CSU Staff Conference Registration Form

Surname: / Title:
First Name:
School/Section: / Job Title:
Campus:
Telephone: / ( ) / Mobile:
Fax: / ( )
Email: / @csu.edu.au

Conference Options

PleaseTick / Registration Fee
(AUD incl GST) / Amount Paid
(please fill in)
Registration closes 18thNovember 2011 / $50.00
I will be attending Welcome Drinks & Nibbles
Wednesday, 30th November 2011 / Included
I will be attending the Conference Dinner
Thursday, 1st December 2011 / Included
Additional person at Welcome drinks & nibbles / $15.00
Additional personat Conference Dinner / $110.00
Optional tours
Departing registration desk
Select one only / A.Winery and Distillery, Bathurst / $5.00
B.Dentistry, Physio and Equine Centre, Orange / $0.00
C.Car Museum Bathurst / $7.50
D.Australian Fossil & Mineral Museum / $7.50
E.Simulation Lab, Paramedic Building, Nursing/ Human Movement Labs,Bathurst / $0.00
Note: Details regarding pick up time will be advised by email
Please enter your total; (including GST) / $
Date:

Name: …………………….……………..………..…Page 2

Travel and Accommodation

The Conferencefee is $50 (per person) plus extras (tours) – regardless of whether you attend 1, 2 or 3 days. This covers all meals included at the Conference, transport and accommodation at the new student residences. If you are travelling by transport organized by the Committee – you will be attending all three days of the Conference. Transport will be provided by either bus or car (depending on your campus location).

Note: Delegates can choose to organise their own transport and accommodation, however, this cost will not be covered by the TechNet Organising Committee and must be covered by your Division/School/Section. You will still be required to pay the Conference fee of $50.00 plus extras.

Please indicate your travel and accommodation preferences

Yes, I will travel by bus/car to the Conference – organised by the Committee.

Yes, I will require accommodation at the Bathurst campus – new student residences.

On: 30th November 1st December

ORI will make my own travel arrangements funded by my Division/School/Section.

Payment Details -CSU Staff

Pleaseuse the Internal Funds Transfer Form attached to make payment (page 4).

Payment Details - Guest

Payment of guest attendance at Welcome Drinks &Nibbles and/or Conference Dinner should be made by completing details below

Cheque/Money Order: Made payable to “Charles Sturt University”

Credit Card: Please tick card type and complete the following:

/ Visa Card / MasterCard

Name on Card …..………………………………………………………………………......

Card Number ……………/……………/…………../...... Card Expiry Date….…/...……......

Cardholder Signature ……………………………...………………………………………………......

Telephone (in case of processing difficulties)...…………………………………………………………………….

TotalPayment: $ ………………………………

Special Needs

Do you have any special needs – eg Dietary requirements, Wheelchair access, etc? If so, please state:

Page 3

Note for GST Purposes

The Australian Number (ABN) for Charles Sturt University is83 878 708 551. Please regard this registration form as a Conference offer. No separate invoice will be issued. Upon payment of the appropriate amount this registration form will be a tax invoice. Please keep a copy of this form for taxation purposes.

Refund Policy

Up to 31st October - 85% refund. From 16th November - no refund. However, a substitute delegate, within the same organisation, may be nominated.

Return this Form by post/fax or email to:Enquires to:

Kathy McLennanKathy McLennan

Administrative Officer (Strategic Leadership Programs)Telephone: 02 69 332716

Division of Human Resources (Organisational & People Capability)Or

PO Box 588Angela Fuller

Wagga Wagga NSW 2678 Telephone: 02 69 332212

Facsimile: 02 69 332886

Email:

Office Use Only:

Detail Code: DE83Cashier: Forward receipt to Kathy McLennan (HR/OPC, David Asimus Court, Wagga Wagga Campus)

/ FUNDS/TRANSACTION TRANSFER REQUEST
1. INSTRUCTIONS
Form to be used to request: / - Transfers of funds or of budgets between Codes;
- Transfers of expenditure or income transactions to correct codes.
Form to be authorised by: / Budget Centre Manager for the code from which funds or budget are to be taken.
Completed form to be forwarded to: / Ledgers Clerk, Division of Finance – Wagga Wagga campus
2. DETAILS
TRANSFER FUNDS OR TRANSACTION
FROM / TO / AMOUNT / FUNDS/
Fund / Org / Acct / Prog / Fund / Org / Acct / Prog / $ / INC/EXP / TRANSACTION DESCRIPTION
A102 / 6507 / 535 / 5751 / Registration for TechNet Conference, Bathurst 30th November to 2nd December, 2011
Brief reason for transfer (attach any appropriate documentation or authority).
3. AUTHORITIES / Finance Use Only
Printed Name of Originator / Date
Budget Centre Manager / Printed Name of Signatory /

Date

/ Transfer Approved / Date
FF19.1007