2007 Registration Form

First Name

Last Name

Preferred name on badge

Company Name

Mailing Address

City

State

Post Code

Email

Phone Number (work)

Fax Number

Mobile Number

Registration Fees

Early Bird Registration - AUD $550.00 Inc GST (till 19/03/07)

Standard Registration - AUD $650.00 Inc GST (till 16/04/07)

Late Registration - AUD $760.00 Inc GST (after 16/04/07)

Additional Tickets

Additional tickets can be purchased for accompanying persons/guests

Welcome Function tickets - AUD $70 Inc GST - No of tickets

Conference Dinner tickets - AUD $110 Inc GST - No of tickets

A Day at the Footy - AUD $33 Inc GST - Additional Ticket

Name of Accompanying Person/s: -

Total Payment -

Will delegate be attending Welcome Function?

Will delegate be attending Conference Dinner?

Will delegate be attending the Day at the Footy?

Please specify any special Requirements: ie Dietary, Other:

Please nominate your favourite AFL Football team:

Payment Methods

Please tick the relevant box to indicate your method of payment

Send a Cheque

Electronic Funds Transfer (EFT)

Send Cheque to:

FMMS User Conference
C/O KDR Creative Software Pty Ltd
Attn: Dianne Ramsey
Suite 15, 85 Turner Street
Port Melbourne, Vic 3207

Phone:(03) 9646 1788
Fax:(03) 9646 9680
Email: conference(at)kdr.com.au

EFT Details

Account Details will be supplied to the email address provided.