Round Table on Information Access for People with Print Disabilities Inc. 2008 National Conference Melbourne - Victoria The Power of Cross Sector Collaboration: Investigating working relationships across the private, public, government and not-for-profit sectors. 11th April – 14th April 2008 Conference Registration Form The aim of Round Table is to facilitate and influence the production and use of quality accessible formats for and by people with print disabilities. By journeying through recreation, leisure, education, government, employment, and legislation, the 2008 Round Table Conference will highlight and celebrate achievements in technology and accessible information, and the impact these have on lifestyle choices of the individual. Venue Saville on Russell, Russell Street Melbourne 3000 Victoria, Australia Visit Round Table at www.e-bility.com.au/roundtable/ Victoria "You'll love every piece of Victoria" Visit us at www.visitvictoria.com Conference Payments, Enquiries and Conference Registrations to: Tammy Axelsen, Administrative Officer Round Table on Information Access for People with Print Disabilities Inc PO Box 229, North Hobart, Tasmania 7002 Australia Phone Mobile 0417 101 418 Fax +61 3 6265 1519 Email roundtableadmn@bigpond.com Conference Registration Form & Tax Invoice 2008 Round Table National Conference, Melbourne, Friday 11th April – Monday 14th April 2008 Round Table on Information Access for People with Print Disabilities Inc. ABN 6 4 9 4 1 9 9 0 1 5 3 Section 1 Personal Details – Please Print Title (Mr/Mrs/Ms/Dr/etc): Name: Name for Conference Badge: Organisation: Mailing Address: Telephone: Mobile: Fax: Email: Accessibility requirements (Please indicate - Braille, Large print, Electronic, Audio induction loop, Wheelchair, Other): Guide Dog (If yes, name of Guide Dog): Dietary requirements - Conference tea breaks and lunches will all comprise of 50% vegetarian, this may include dairy (eg milk, cheese, eggs). If you have other specific dietary requirements, please clearly indicate: Section 2 Conference Fees (all fees are in Australian dollars) FaCSIA Grant for Conference Attendance Self funded consumers may apply for assistance towards travel and / or accommodation costs. If you wish to be considered fore this funding, please complete and submit the attached separate FaCSIA Application Form by Wednesday 20th February 2008. Conference Registration Fees Full Conference (4 days) Round Table members $435.00, Non-Round Table members $550.00 OR Selected days (Fri/Sat/Sun) Round Table members $125.00 per day, Non-Round Table members $155.00 per day Monday (includes lunch) Round Table Member $90.00, Non Round Table Members $100.00 Places are available for self-funded individuals with a print disability at the concession rate of $60.00 per day. Total Registration Cost: $ Please indicate which day/s and which Accessible Information Guidelines Sessions you will be attending below. Full conference (Yes/No): or Friday 11th April (Yes/No): Saturday 12th April (Yes/No): Sunday 13th April (Yes/No): Attending Large Print Guidelines Update (Yes/No): Attending Guidelines for Accessible Examinations Discussion presentation (Yes/No): Monday 14th April (Yes/No): Attending E-text Guidelines Update (Yes/No): Attending AGM (Yes/No): Section 3 Conference Dinner The 2008 Conference Dinner will be held at the Saville on Russell, on Sunday, 13th April 2008 at 7.00 pm. Cost $48.00 per person. (All beverages to be purchased individually). The Conference Dinner is a three course, alternate drop down menu, plus tea and coffee, with two options in each of the three courses. Vegetarian options and special dietary requirements will be catered for on request. I will be attending the Conference Dinner (Yes/No): I will be accompanied to the dinner by: I require a vegetarian meal (Yes/No): I have special dietary requirements: Please include your payment for the dinner with the Conference Registration payment. Section 4 Accommodation All Delegates are responsible for their own accommodation arrangements and payments. Please book your accommodation directly with the Saville on Russell. In order to ensure room availability and to access the special rates, accommodation bookings must be made direct with the hotel BY WEDNESDAY 12th MARCH 2008 and please quote 401293 as the Round Table Conference Accommodation Code. The special rate cannot be guaranteed after this date. All bookings are subject to availability at the time your booking is made. For Conference Accommodation Reservations please contact the hotel direct. Either Ashley, Gina or Jodie Email russellst.res@savillehotelgroup.com Or Phone Ashley +61 3 9915 2507, or Jodie +61 3 9915 2508, or Gina +61 3 9915 2506 All rates are in Australian dollars. If requiring twin bed occupancy please specify clearly. * Studio room – $167.00 per room per night, room only * One Bedroom Apartment – $188.00 per room per night, room only * Two Bedroom Apartment – $250.00 per room per night, room only Breakfast – an optional special Breakfast Rate for Delegates of $20.00 per person, per day, Restaurant or Room Service is available. Please notify the staff at the Saville on Russell of any special needs at the time of booking. Car Parking The Car park is fully operated by “EziPark Ltd” all enquiries should be directed to their office on 1800456732. Conference Proceedings Conference proceedings will be available on the Round Table website following the conference. Website www.e-bility.com/roundtable Please send Conference Registration Form and Payment by Wednesday 5th March 2008 to: Tammy Axelsen, Administrative Officer Round Table on Information Access for People with Print Disabilities Inc PO Box 229, North Hobart 7002 Tasmania, Australia. Email roundtableadmn@bigpond.com Phone Mobile 0417 101 418 Fax +61 3 6265 1519 Should you have any special requirement related to your conference payment such as acknowledgement of registration, or require a payment receipt please indicate below. Payment Summary Section 2: Registration Fees $ Section 3: Conference Dinner $ PAYMENT TOTAL ($AUS) $ If making one payment for multiple delegates from the same organisation please staple registration details for EACH delegate (pages 2 & 3) to this Payment Summary sheet and list the delegates below. Each delegate is required to sign the declaration at the bottom of this page. Payment Options Cheque or money order made payable to Round Table on Information Access, Direct deposit to Round Table’s bank account at the National Australia Bank. BSB Number: 083 522 Account Number: 457421243 Account Name: Round Table on Information Access Please clearly identify your deposit with the name of the payee. If using this method of payment please forward registration details and date of direct credit, to roundtableadmn@bigpond.com or by mail to the address on page 8 of this form. Credit Card. We are only able to accept charges to Visa or Mastercard credit cards Credit Card Authorisation Card Type (Visa or Mastercard): Card Number: Expiry Date: Cardholder Name: Cardholder Signature: Amount $ In registering for this Conference, relevant details (name/organisation/address) will be incorporated into a delegate list for the benefit of all delegates, and may also be made available (if necessary) to parties directly related to the Conference. I consent to the collection, use and disclosure of information provided in this registration form in accordance with and for the purpose outlined above. Signature. Date. Round Table Tax Invoice This document will be a Tax Invoice when you make payment. Round Table on Information Access for People with Print Disabilities Inc. ABN 6 4 9 4 1 9 9 0 1 5 3 2008 Conference Expenses Name: Organisation: Conference Registration: $AUS Conference Dinner: $AUS TOTAL: $AUS All prices include GST. GST component is 1/11th of above total $AUS. Please make cheques payable to Round Table. Registration form and payment should be sent to: Tammy Axelsen Administrative Officer Round Table on Information Access for People with Print Disabilities Inc. PO Box 229 NORTH HOBART 7002 Tasmania, Australia Email roundtableadmn@bigpond.com Fax +61 3 6265 1519 End of file.