Convention Registration Form

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Australia District 2015 Convention

Let’s Make History

Host Club – Port Phillip Friday 28 – Saturday 29 August 2015 BellCity 215 Bell Street, Preston, Melbourne, Victoria (www.bellcity.com.au)

Convention Registration Form Name:

Partner Name:

Postal Address:

Postal Address:

Email Address

Email Address:

Phone:

Phone:

Club:

Club:

First Timer

Yes

Delegate Status

No D

LM

First Timer DAL

Yes

Delegate Status

REGISTRATION FUNCTIONS AND MEALS

COST

No D

MEMBER

LM

DAL PARTNER

TOTAL

Fri 28 Aug:

Registration

$60

$ 0.00

Fri 28 Aug:

Welcome Reception

$25

$ 0.00

(N/A to First Timers)

(includes nibbles, first drink, cash bar thereafter) Sat 29 Aug:

Full day

$100

$ 0.00

(includes Breakfast, Morn / Aft tea, Lunch, post meeting drinks) Birthday Party: Sit down 2 course meal, cash bar (Dress: suit or party dress) Additional Guests welcome. No: 0

$65

$65

$ 0.00 Guests SUB TOTAL

$ 0.00 $ 0.00

SUBTOTAL less deposit if applicable TOTAL

$ 0.00

Special Dietary / Access / Other Needs: PAYMENT

the page, just drag it.]

Convention Registration Forms must be accompanied with full payment or emailed after direct deposit. Cheque or Money order to be made payable to “Kiwanis Port Phillip” Electronic Funds Transfer available: KIWANIS CLUB OF PORT PHILLIP INC BSB: 633 000 ACC NO: 1476 03021

(include surname as reference)

Send Registration form and/or payment to: Registration Secretary 42 Settlement Road Belmont, Vic 3216 or [email protected] Enquiries: Jenny and Sam Neumann Ph: 03 5244 1532 (h) or Sam 0400 602 417 or Jenny 0402 268 619 We may not be able to answer during business hours, leave a message and we will return your call. NOTES: 

Check the Convention website for updates at www.kiwanis.org.au



Travel to/from venue will be all your own arrangements.



Refund policy: Full refund if booking cancelled before 20 July 2015.

Registration Form 17/03/2015

Book your own accommodation and check with venue for cancellation policy. We have discussed a “Kiwanis Rate” with the venue however better rates may be available on the internet. Please negotiate as best you can.

Caravan Parks

Motels

Mantra Bell City - 4.5 Stars - $149 Manhattan

Melbourne Caravan Park

215 Bell Street, Preston, VIC 3072 t. (03) 9485 1000 f. (03) 9485 0066 e. [email protected] w. www.mantra.com.au/bell-city

265 Elizabeth Street, Coburg, MELBOURNE, 3058 Ph: 03 9353 8222

refer to Mantra Bell City Accommodation Fact Sheet at the

Powered Site (with ensuite)

link above

Unpowered Site

Same site as Convention venues

Cabins - couple

http://www.melbournebig4.com.au/

Bell City BreakFree - 3.5 Stars - $99 King / Queen / Twin 215 Bell Street Preston VIC 3072 t. (03) 9485 1000 f. (03) 9485 0056 e. [email protected] http://www.bellcity.com.au/hotel/breakfree-bell-city/ Same site as Convention venues

Caravan Park

We look forward to welcoming you to the 47th Australia District Kiwanis Convention Registration Form 17/03/2015