Register for the NZSA2008 Conference,
University of Waikato
Fields denoted * must be filled
Tax Invoice/Receipt
New Zealand Statistical Association (Conference Division)
GST: 92 640 744

Personal Details:

Title:

Surname or Family Name:*

First or Given Name:*

Address:*
 
 

Country:

Phone:*

Fax:

Email:*

New Zealand Student:
 
Registration:
Registration fees are (a) $200 for NZSA and SSAI members, $100 for students, before 15 August 2008 and (b) $240 for members and $120 for students after 15 August 2008. There is a $80 surcharge for non–members, which gives NZSA membership for one year. Local teachers may attend the Education sessions at no charge (but must register for catering purposes).

Registration type:  

If you chose  'I am attending the Education sessions only: free'
for registration type, please enter the name of your New Zealand school:

Privacy Declaration: I give consent for my name to appear on the participant list

I plan to attend the Sunday evening reception (no charge to registrants)     No Yes

Dietary and any other special needs:

Brookfield Student Accommodation, which is about 2 km from the university is offering single rooms: total $80 for 1 or 2 nights; total $110 for 3 to 7 nights.
Which nights, if any, do you wish to stay at Brookfield Student Accommodation?

I plan to stay at Brookfield Student Accommodation and I wish to have wireless internet available:
       No Yes

Option / Number attending

Cost

Conference Registration

(automatic)

Conference Dinner ($50)

Nights at Brookfield Student Accommodation

Total

 
Payment Details:
Payment by cheque: Make cheque out to "NZSA"

Payment by Direct Credit to NZSA
Account Number 02 0500 0019525 00:

Please ensure that your name will appear on our bank statement
(e.g., NZSA Conference, Mary Smith, Dunedin).
Payment by Mastercard or Visa:

The NZSA Email address and Website are not secured sites so confidentiality of credit card email transmission cannot be guaranteed.
If paying by credit card, please submit electronic form without credit card details and supply full information on a hard copy

 Credit Card number
 Cardholder's name
 Expiry date
  Amount: $NZ
  Signature:  
     
Date:
 
Send this form using the Submit button
and print and post with cheque made out to "NZSA"
or with credit card details to
Harold Henderson, Statistics, AgResearch, Ruakura,
Private Bag 3123, Hamilton 3240, New Zealand.
Phone Harold using a local AgResearch number and ask for extension 5151 or by
DDI Phone: +64 7 838-5151; Fax: +64 7 838-5012

For more information contact Harold Henderson.