Dinner 2013 registration form

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Shadow Minister for Industry Ms Sophie Mirabella Industry Capability Network Mr. Derek Lark addresses Plastics Industry Thursday July 18, 2013 6.30pm for 7.00pm Kooyong Room Kooyong Lawn Tennis Club 489 Glenferrie Rd., Kooyong Victoria 3144 Registration Form Company: Email: Name/s: 1/ 2/ 3/ 4/ Dietary Requirements: Number attending @ $130.00 person (Plus GST) Total Payment: $ Cheque: ( ) Attach cheque & mail to: PlastixANZ P.O Box 254 Hallam 3803 Electronic Funds Transfer: ( ) Email registration form to: [email protected] EFT funds to: National Australia Bank Grange Products Pty. Ltd. BSB: 083 125 Account: 490 130 042 Tax invoice will be forwarded on receipt of payment Cancellations cannot be accepted less than 7 Days prior to start of series PayPal: ( ) Email registration form to: [email protected] PayPal Buy Now button at bottom of registration & information page on website - click here

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Registration form for Plastics Industry Dinner 2013 -- featuring Shadow Minister for Manufacturing

Transcript of Dinner 2013 registration form

Page 1: Dinner 2013 registration form

Shadow Minister for Industry Ms Sophie MirabellaIndustry Capability Network Mr. Derek Lark

addresses Plastics Industry

Thursday July 18, 20136.30pm for 7.00pm

Kooyong RoomKooyong Lawn Tennis Club

489 Glenferrie Rd.,Kooyong

Victoria 3144

Registration FormCompany:

Email:

Name/s:1/

2/

3/

4/

Dietary Requirements:

Number attending @ $130.00 person (Plus GST)

Total Payment: $

Cheque:   (    )  "

Attach cheque & mail to:" " "

PlastixANZ" " " " "P.O Box 254 "" " " "Hallam  3803

Electronic Funds Transfer: ( )Email registration form to: [email protected]

EFT funds to:National Australia BankGrange Products Pty. Ltd.BSB: 083 125Account: 490 130 042

Tax invoice will be forwarded on receipt of payment

Cancellations cannot be accepted less than 7 Days prior to start of series

PayPal: ( ) Email registration form to: [email protected]

PayPal Buy Now button at bottom of registration & information page on website - click here

mailto:[email protected]?subject=
mailto:[email protected]?subject=
mailto:[email protected]
mailto:[email protected]
http://www.plastixanz.com.au/admin_subsite.asp?SubsiteID=75
http://www.plastixanz.com.au/admin_subsite.asp?SubsiteID=75

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