Event Setup
Company Details/Contact Person (Organiser of Event)
Company Name*
Company Business Number
Company Address*
(for invoices)

State Zip/Postcode
Contact Person *
Phone* - Fax  - 
Company Website
Event Details
Event Name*
Date Start*    Date End*
Times of Event to
Short Summary*
(approx 3 lines)
Description / Details
Event Venue
Max number Registrants NOTE: ALL Prices to include TAX if applicable
Registrant Costs
Type Cost ($) Earlybird ($)
Registration Cutoff(Last Day)*
Early Bird Cutoff
(Last Day)
Workshops Details
Name Date Cost ($)
Social Event Details
Name Date Cost ($)
Costs and Payments
Deposits Permitted Yes No    Amount ($) Amount (%)
Credit Card Pmts Yes No   
cheque Pmts Yes No    (If Yes then supply details below)

cheque made to name:                
cheque send to address:

Direct Deposit Pmts
Yes No
Extras/Options Required on Registration Form
Yes No
(List Accommodation venues in Special Requirements below)
Yes No
Yes No
Yes No
Extra Data Required

Yes No (eg M/ship Number, Shirt size etc)
Special Requirements
(eg Accommodation Venues)
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