Registration Form

The 8th Annual Winter Research Forum 2017 will be held from 5pm Wednesday August 23 until 11am Friday August 25th at the Crowne Plaza, Queenstown, New Zealand.

Section A: Your Details


Section B: Meeting Registration Fees

Online registrations will close Friday 4th August 2017. Registrations received after this time will attract an additional 20% manual processing fee. Prices are in Australian dollars (No GST payable). Registration for the CTG Winter Research Forum includes one complimentary ticket to the CTG Winter Research Forum Dinner (evening of Wednesday 23rd August). Please indicate that you wish to attend the Dinner to reserve your seat. Additional Dinner tickets may be purchased subject to availability. A cancellation fee of $60 will apply to any registration cancelled before Friday 4th August 2017. Please note that no refund will be given should you elect to cancel after Friday 4th August 2017.

Meeting:

CTG Winter Research Forum - Full registration (August 23 - 25 includes Forum Dinner ticket)
        Medical staff (Members $550, Non-Members $836)
        Research/Trainee/Registrar/Nursing staff (Members $380, Non-Members $670)

Should you require single day registration please contact the CTG Office.


Section C: Networking Opportunities

The CTG Winter Research Forum Dinner will be held the evening of Wednesday 23rd August. This event will provide an opportunity for delegates to network and socialise over dinner.

Yes    No

Number of extra Forum Dinner tickets required?:
@ $150

Additional dinner tickets are subject to availability

Section D: Payment
Total amount:

No GST payable

Credit

Please note: Credit card payments are processed through Commonwealth bank's payment gateway, BPOINT.

Cheque

Please post a cheque to: CTG Executive Assistant
Simone Rickerby

ANZICS Clinical Trials Group
PO Box 164
CARLTON SOUTH, VIC 3053

Invoice