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National Public Affairs Convention Registration
I am a financial Alliance Member:
Yes
No
Membership Number:
I would like to register at:
$350 inc GST - Media Alliance members
$450 inc GST - non-profit organisation rate
$500 inc GST - non-members rate
Name:
Position:
Organisation:
Street Address:
Town
State:
Post Code:
Work Phone:
Mobile Phone:
Email Address:
I would like to pay via:
Credit Card
Invoice
Card Type:
Mastercard
American Express
Bankcard
Visa Card
Card Holder Name:
Card Number:
Expiry Date:
I would like to attend the welcome drinks (no extra cost):
How did you find out about the convention?
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Hosted By
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