28-30th July
Brisbane Convention Centre

WORKSHOP REGISTRATION FORM

*Please note: Workshop costs are not included in the CMGA'98 Registration fee.

If you wish to register for either or both of the Pre-Conference Workshops please PRINT this form, complete details and send with payment to:

CMG Australia,
PO Box 516, TURRAMURRA, NSW 2074, Australia.

Delegate Information

Please Tick Mr  Mrs  Miss  Ms  Dr 

Surname……………………………………………………………………………………………………………………

Given Name………………………………………………………………………………………………………………

Position/Title ………………………………………………………………………………………………………………

Company…………………………………………………………………………………………………………………

Postal Address ……………………………………………………………………………………………………………

State………………..Postcode……………………………………………………………………………………………

Country……………………………………………………………………………………………………………………

Telephone………………..Fax ……………………………………………………………………………………………

E- mail……………………………………………………………………………………………………………………

Preferred Name for Badge ………………………………………………………………………………………………

Registration

Please indicate seminar choice(s) by ticking appropriate box(es)

Steve Samson Workshop
Monday 27th July 9.30am - 12.30pm
(includes morning tea) cost $245 

Tom Beretvas
Monday 27th July 1.30pm - 4.30pm
(includes afternoon tea) cost $245 

Both workshops cost $440 

Total Payment Enclosed $_____

How to Pay

By cheque in AUD, payable to CMGA'98 Conference

By Credit Card - please tick choice
Bankcard  Mastercard  Visa  American Express

Card Number…………………………………………………………………
Expiry date……………………………………………………………………
Name of Cardholder…………………………………………………………
Signature of Cardholder……………………………………………………

PLEASE PRINT AND RETURN THIS FORM WITH PAYMENT TO:

CMGA'98 Conference,
PO Box 516,
TURRAMURRA, NSW 2074
Australia.

REGISTRATION ENQUIRIES

Telephone +61 2 9983 0122 Fax +61 2 9488 7496



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