Apr 27, 2018 - Cost includes all Conference events (Breakfast Workshop and ... FUNDS TRANSFER : Pastoralists & Grazi
REGISTRATION FORM Kimberley Pastoral Conference Friday 27 April 2018 Mangrove Hotel, BROOME WA
PGA KIMBERLEY PASTORAL CONFERENCE TOTAL COST per person
Members $100
Non-Members $200
TOTAL $ _________
Cost includes all Conference events (Breakfast Workshop and Conference Day) BREAKFAST, Morning Tea, LUNCH and DINNER NUMBER OF ATTENDEES Please provide numbers for CATERING PURPOSES
Members
Non Members
TOTAL
PGA Breakfast Workshop (7am start) PGA Kimberley Pastoral Conference DAY (9am start) PGA Kimberley Division AGM (3.15pm - MEMBERS ONLY) PGA Conference BBQ Dinner (6pm - Dinner Only)
COMPANY NAME ______________________________ CONTACT PERSON ____________________________________ EMAIL ______________________________________ ADDRESS ____________________________________________ PHONE _____________________________________
MOBILE ________________________________________
ATTENDEE 1 NAME ___________________________________________
TITLE _________________________________________
ATTENDEE 2 NAME ___________________________________________ PAYMENT OPTIONS:
CHEQUE : Payable to PGA
ELECTRONIC FUNDS TRANSFER :
TITLE _________________________________________ or
Pastoralists & Graziers Association of WA (Inc) BSB : 016 002 ACCOUNT : 4213 61322
PLEASE forward PGA a copy of your EFT confirmation payment so that we have a record to
[email protected] or Fax 9485 0299
CREDIT CARD:
Master Card
Visa
Card No __________________________________________
Card Holder _________________________________
Signature _________________________________________
Expiry Date ____________ __________
Tax Invoice Required YES / NO
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