Mackay Training Registration Form January to June 2015 Venue: Mackay Youth Justice Service Centre, 41 Gordon Street Mackay Attendee details (PLEASE USE BLOCK LETTERS) Title First name Last name Ph Position Employer Special/Dietary Requirements Courses (please tick the relevant boxes) Price (inc Course name Time Date GST) Contact Officer $354 9am 4pm 25th February – Introduction to the Anti-Discrimination Act for 8:30am – $177 26th February Managers 12:30pm 1:30pm – $88.50 26th February Introduction to the Anti-Discrimination Act 3:30pm Payment method Note: Prices valid 01/07/15 to 30/06/16 Direct deposit (BSB No: 064013 Account No: 10006392) Date deposited Cheque attached Make payable to the Anti-Discrimination Commission Queensland – Credit Card (a tax invoice/receipt will be sent) Visa Mastercard Card number: Expiry date: Name on card: Signature: Invoice (a tax invoice will be sent) Correct Entity Name to be invoiced: ABN/ACN: (check with finance department) Invoice address: Postcode How to register Complete the form and return: email to training@adcq.qld.gov.au | fax to (07) 3247 0960 | or post to ADCQ, Po Box 15565, City East, QLD 4002 We will send you a confirmation email and other details before the session. If you have any questions about your registration please phone 1300 130 670, TTY 1300 130 680 Cancellation Information If you are unable to attend a training session, another person from your organisation is welcome. Cancellations giving a week’s notice will receive a full refund. (See Fee for Service Guidelines - www.adcq.qld.gov.au) Where did you find out about this training? Website Newsletter Other (Please specify) Tick box if you DO NOT wish to receive electronic updates from ADCQ Office use only Accounts Receivable – Name/Position Signature Date Approved by Processed by Posted by Invoice No. Entered into CRM
Mackay Training Registration Form January to June 2015 Venue: Mackay Youth Justice Service Centre, 41 Gordon Street Mackay Attendee details (PLEASE USE BLOCK LETTERS) Title First name Last name Ph Position Employer Special/Dietary Requirements Courses (please tick the relevant boxes) Course name Price (inc GST) Time Date Contact Officer $354 9am – 4pm 25th February Introduction to the Anti-Discrimination Act for Managers $177 8:30am – 12:30pm 26th February Introduction to the Anti-Discrimination Act $88.50 1:30pm – 3:30pm 26th February Payment method Note: Prices valid 01/07/15 to 30/06/16 Direct deposit (BSB No: 064013 Account No: 10006392) Date deposited Cheque attached – Make payable to the Anti-Discrimination Commission Queensland Credit Card (a tax invoice/receipt will be sent) Visa Mastercard Card number: Expiry date: Name on card: Signature: Invoice (a tax invoice will be sent) Correct Entity Name to be invoiced: (check with finance department) ABN/ACN: Invoice address: Postcode How to register Complete the form and return: email to training@adcq.qld.gov.au | fax to (07) 3247 0960 | or post to ADCQ, Po Box 15565, City East, QLD 4002 We will send you a confirmation email and other details before the session. If you have any questions about your registration please phone 1300 130 670, TTY 1300 130 680 Cancellation Information If you are unable to attend a training session, another person from your organisation is welcome. Cancellations giving a week’s notice will receive a full refund. (See Fee for Service Guidelines - www.adcq.qld.gov.au) Where did you find out about this training? Website Newsletter Other (Please specify) Tick box if you DO NOT wish to receive electronic updates from ADCQ Office use only – Accounts Receivable Name/Position Signature Date Approved by Processed by Posted by Invoice No. Entered into CRM
RegForm2015February_Mackay.docx