WHERS

General Details

Title	Please select an item.*
First Name	* A value is required. Name on Badge
Surname	A value is required.*
Address	A value is required.*
City/Town
State	(If other)
Country	Please select an item.
Postcode	A value is required.Invalid format.*
Telephone	A value is required.Please include area code (10 digit number required)*
Facsimile
Email	A value is required.Invalid format.*
RACGP QA+CE Number
Special Requirements

Registration Fees

Full Registration ($520 before 16 January 2009, $570 after 16 January 2009)
Full registration includes lunch, Canapes and Drinks events.
OR
Individual Day Registration Please enter a value.

Select the days you wish to register for:

Friday	$250
Saturday	$250
Sunday	$140

Extra Tickets

Friday Lunch @ $50 each Please select an item.

Friday Canapes and Drinks @ $30 each Please select an item.

Saturday Lunch @ $50 each Please select an item.

Saturday Canapes and Drinks @ $30 each Please select an item.

Full Guest @ $180 each Please select an item.

Accommodation

Sheraton Mirage
See direct online booking or download faxable form.

Palazzo Versace
Either use the faxable form to book your accommodation or you can pay a deposit of one night's room tariff to secure your booking at Palazzo Versace

Palazzo Versace Deposit $384 Yes No

Delegate Sharing Room Yes No

Name of Shared Delegate A value is required.

Check In Check Out

Room Configuration

(Max 2 adults and 2 children per room)

Single Double Twin (2xdouble beds)

Comments:

Register for the 2009 Conference