RACI NATURAL PRODUCTS CHEMISTRY GROUP ANNUAL ONE-DAY SYMPOSIUM 2015 Registration Form Attendee Information Name: Title: First Name Last Name . Name for Badge . Organisation: . Phone: Email: Address: Street Address City State Postcode YES NO I wish to present orally (tick) YES NO I wish to present a poster (tick) Payment Method Registration fee includes lunch, tea breaks, abstract booklet. Drinks and canapés to be provided after the event and are included in the registration fee. *As is our custom, students giving an oral presentation will have their registration fee waived. Prices shown are for registration up to 2 September 2015. After this date, registration costs are $10.00 extra.
RACI NATURAL PRODUCTS CHEMISTRY GROUP ANNUAL ONE-DAY SYMPOSIUM 2015 Registration Form Attendee Information Name: Title: First Name Last Name . Name for Badge . Organisation: . Phone: Email: Address: Street Address City State Postcode I wish to present orally (tick) YES NO I wish to present a poster (tick) YES NO Payment Method Registration fee includes lunch, tea breaks, abstract booklet. Drinks and canapés to be provided after the event and are included in the registration fee. *As is our custom, students giving an oral presentation will have their registration fee waived. Prices shown are for registration up to 2 September 2015. After this date, registration costs are $10.00 extra.
040915_RACI_Registration_Form.docx