Annual Conference Registration

Name*
Prefix First Last
Preferred name to appear on name badge:
Company or Firm
Address*
Street Address City State Postcode Country
Phone
Mobile
Email*
Are you a member of IPSANZ?*
- Yes
- No
Do not add me the delegate list
Please tick the box if you DO NOT wish for your details to be included/published in the delegate list contained in the delegate’s material
- Do not include me in the delegate list
Social functions
Please indicate your attendence
- I will be attending the Pre-conference Session Friday, 6 September 2019 between 4:00pm - 5:00pm
- I will be attending the Welcome drinks Friday, 6 September 2019 between 6:00pm - 8:00pm
- I will be attending the Annual General Meeting Saturday, 7 September 2019 5:00pm
- I will be attending the President’s Dinner Saturday evening, 7 September 2019
Delegate registration fees*
Early bird registrations closed 19th July 2019.
Please indicate if you have any special dietary requirements:
Please indicate if you require Airport Transfers
Transfers (Airport)*
No. of people for transfers*
Please enter a number greater than or equal to 1.
Flight details (arrival &/or departure)*
Please complete details for return flights where required.
Name/s (additional persons is an option) Date Airport Flight No. Flight arrival/departure time
Will anyone be accompanying you?
- Yes
Accompanying person name:
Prefix First Last
Accompanying person preferred name to appear on name badge:
Accompanying person dietary requirements:
Please indicate if your accompanying person has any special dietary requirements.
Accompanying Person Registration Fees:
FULL Accompanying person: $495.00 (incl. GST) Includes Friday Welcome drinks Saturday President’s Dinner Sunday Lunch with delegates
Price: $ 495.00
Accommodation - Sofitel Noosa Pacific Resort
Please contact the IPSANZ Secretariat if accommodation is required.
Number of nights
Check in date
Date Format: DD slash MM slash YYYY
Sharing accommodation with
First Last
Buffet breakfast
$25 per person per day (please state how many days)
Price: $ 25.00 Quantity:
Total Price in AUD (inc GST)
$ 0.00
Payment method:*
Please return this registration with your cheque in AUSTRALIAN DOLLARS made PAYABLE TO IPSANZ or payment can be made by EFT (details below):

Payment by electronic transfer:
Account Name: The Intellectual Property Society of Australia and New Zealand Inc. “IPSANZ’
BSB No: 063 009
Account No: 0090 3138

Please confirm payment details by EFT once made, advising reference “SURNAME - 2019 AC”
You will be prompted to pay by credit card after submitting this form.

We will contact you once payment has been confirmed, or if there are any issues. Your details will be recorded even if the credit card payment is unsuccessful so no need to register again. Feel free to contact us directly if you have any concerns.
TAX INVOICE ABN: 66 056 252 558
All fees are quoted in Australian dollars (AUD) and are inclusive of GST (10%)
Please note: No refund is available for registration and accommodation after 19 July 2019. Registrations can be transferred to a substitute delegate at no additional cost, provided the conference secretariat is advised by email, letter or facsimile.

Annual Conference Registration

Annual Conference Registration

IPSANZ

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