MAAOE 4^th International Conference on Organisational Excellence Monday 20, Tuesday 21 and Wednesday 22 October 2003 Melbourne, Victoria, Australia Theme: Excellence in the Face of Crisis Participant Registration Form
Please this application together with payment as indicated below by one of these three options:
1. by post: INTERGON PO Box 2013 South Melbourne, Vic, 3205 Australia							2. by fax: 61+3+9925-1655 3. by email: lboxer@hotmail.com
Please complete entire form in BLOCK LETTERS except where noted
Salutation:	First Name:					Last Name:
Title:					Phone Number:					Fax Number:
Organisation:
Postal Address:
Post Code:			Country:					Email (be case specific):
Conference Fees Includes:				Non-Academic Fee (select)					Full	Prior to 9 May Early Bird
· Proceedings of entire conference				r Full Conference					$1200	$1080
· Lunches and conference dinner
· Australian Goods and Service Tax (GST)				Academic Fee (select)					$950	$855
Notes:				r Full Conference
· All amounts in Australian dollars (AUD)
· 15% will be retained for any refunds				r MAAOE Membership					$50	- - - -
· No refunds after 12 Sep 03				r
· Students may apply for scholarships				r Guest dinner Mon 20 Oct					$100	$90
Fee payable to “Intergon ‘ for MAAOE 20-22 Oct 2003 (pay by): 4.68% Credit Card Processing Fee: r Cheque in AUD (cheque must accompany this form by post) Total: r Credit Card (check: r Visa r Master Card or r Bankcard) - Credit Card Number: ___________________________________________________ - Name on Card: ______________________________________ Exp: _____ / _____ There may be some delay in processing your fee.
									Signature:
NOTES:
Event		Participating	Note Your Special Dietary Requirements (r if used back of page)
Lunches		r Yes r No
Monday Dinner		r Yes r No