registration form - AWS
LDEG
New Zealand
Ensuring Quality Infrastructure
IPWEA
Land Development Engineering Group
INSTITUTE OF PUBLIC WORKS ENGINEERING AUSTRALIASIA
REGISTRATION FORM LDEG FORUM
15-16 March, 2018
The Land Development Journey
HOTEL ARMITAGE, TAURANGA
From Concept to Communities
First Name:
Surname:
Position: Company name:
Postal Address
Business Phone Email Address
Mobile
Special dietary requirements or disabilities
REGISTRATION FEES Day 1 only IPWEA NZ MEMBER IPWEA NZ NON MEMBER
$350 + GST = $402.50 $400 + GST = $460.00
2 Day Registration (Day 1 and Field Tour) IPWEA NZ MEMBER IPWEA NZ NON MEMBER
$410 + GST = $471.50 $460 + GST = $529.00
TOTAL PAYMENT
$
IPWEA NZ GST No: 21 200 239
PAYMENT OPTIONS
Cheque enclosed (payable to IPWEA NZ) Order no: Visa / Mastercard
Name on card:
Credit Card number:
Visa/Master Card: Cardholders Signature:
Expiry Date:
CCV:
To complete this form electronically and submit online, first download and save a copy first, then re-open in Adobe Reader or another Adobe programme to use the “submit form” feature. Otherwise you can print/scan and email to: [email protected]. Alternatively you can send your completed registration form to the following: By Post to – IPWEA NZ, P O Box 25415, Wellington 6146 By Fax to – 07 867 7680. The Privacy Act 1993 requires that, before your name and address details can be published in the list of delegates either for distribution to fellow delegates or any other party, you must give your consent. If you DO NOT wish your name and details to be made available please tick this box
SUBMIT FORM New Zealand
WWW.IPWEA.ORG/NEWZEALAND
IPWEA
INSTITUTE OF PUBLIC WORKS ENGINEERING AUSTRALIASIA
New Zealand
Ensuring Quality Infrastructure
IPWEA
Land Development Engineering Group
INSTITUTE OF PUBLIC WORKS ENGINEERING AUSTRALIASIA
REGISTRATION FORM LDEG FORUM
15-16 March, 2018
The Land Development Journey
HOTEL ARMITAGE, TAURANGA
From Concept to Communities
First Name:
Surname:
Position: Company name:
Postal Address
Business Phone Email Address
Mobile
Special dietary requirements or disabilities
REGISTRATION FEES Day 1 only IPWEA NZ MEMBER IPWEA NZ NON MEMBER
$350 + GST = $402.50 $400 + GST = $460.00
2 Day Registration (Day 1 and Field Tour) IPWEA NZ MEMBER IPWEA NZ NON MEMBER
$410 + GST = $471.50 $460 + GST = $529.00
TOTAL PAYMENT
$
IPWEA NZ GST No: 21 200 239
PAYMENT OPTIONS
Cheque enclosed (payable to IPWEA NZ) Order no: Visa / Mastercard
Name on card:
Credit Card number:
Visa/Master Card: Cardholders Signature:
Expiry Date:
CCV:
To complete this form electronically and submit online, first download and save a copy first, then re-open in Adobe Reader or another Adobe programme to use the “submit form” feature. Otherwise you can print/scan and email to: [email protected]. Alternatively you can send your completed registration form to the following: By Post to – IPWEA NZ, P O Box 25415, Wellington 6146 By Fax to – 07 867 7680. The Privacy Act 1993 requires that, before your name and address details can be published in the list of delegates either for distribution to fellow delegates or any other party, you must give your consent. If you DO NOT wish your name and details to be made available please tick this box
SUBMIT FORM New Zealand
WWW.IPWEA.ORG/NEWZEALAND
IPWEA
INSTITUTE OF PUBLIC WORKS ENGINEERING AUSTRALIASIA
