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Registration FormPrint out this form, complete it, and mail or fax it to Ms. Lillian Cheung, Department of Geomatics, The University of Melbourne. Refer to Registration Information for complete conference descriptions and price information. Mail or fax this form with payment to: Ms. Lillian Cheung, Phone: +61 3 9344 4431 Registration FeesAUD $400 for early registrations (before 30 June 1999)
Note: Fees increase AUD $50 after 30 June 1999 Total Registration FeesTotal Amount Enclosed - AUD$ __________________ Check Number/Bank Name: . . . . . . . . . . . . . . . . . . . . . . . Note: Payments must be in Australian Dollars
equivalent. RegistrantNote: Please type or print in capital letters Family/Last/Given Name: . . . . . . . . . . . . . . . . . . . . . . . . . . First Name: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Organisation Title:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Organisation/Company Name: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Mailing/Street Address: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . City: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . State/Province: (if applicable) . . . . . . . . . . . . . . . . . . . . . . Zip/Postal Code: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Country: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Telephone Number: (Include country code). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Fax Number: (Include country code) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . E-mail address: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Do You Wish to Attend the Optional LAND VICTORIA visit?
Authorised by: Francisco Escobar |