COMBINED EMERGENCY SERVICES
Seminar Committee Inc.

21st ANNUAL SEMINAR


Under Croft Theatre, La Trobe University
27th November 1999


REGISTRATION FORM
Please fill out the following order and press "Send Registration".
Then I'll send you your tickets as soon I receive a money order or cheque for the amount required.
(it's a good idea to put a copy of this form in with the money order or cheque so I know who it's from)

Please complete and return this form with a
STAMPED SELF ADDRESSED ENVELOPE TO:
Secretary - Mr. Robert M Wardzynski


P.O. Box 52 Briar Hill, Victoria, Australia 3088
Tel:A/H (03) 9432 1131 Fax: (03) 9432 3656 Mob: 0408 991 307
Email:  cessi@vicnet.net.au

SURNAME:

GIVEN NAMES: TITLE:

ADDRESS:

CITY:

STATE: POSTCODE:

CONTACT NUMBER: ( A/H )

CONTACT NUMBER: ( BUS: )

ORGANISATION:

REGISTRATION FEES
Please place a tick in the box for your Preference's
One Form Only Per Person
One Day Only Saturday 27th $50.00
Bar-B-Que ( Saturday Evening ) $15.00

*Accomodation @ $45.00 per night
( Including Breakfast )

Friday Night 26th November 1999
Saturday Night 27th November 1999
Sunday Night 28th November 1999

Enter the total amount of your order in the box below

Total Fees Enclosed: $

(*Must be booked by no later than 9th November 1999)
(No refund for late accomodation cancellation)


Make Cheques Crossed & Payable to Combined Emergency Services Seminar Committee or CESSCI

Please copy this page and post it together with your CHEQUE & S.S.A.E. after you have completed your details fully to the above address, to confirm your booking, and we will post out your tickets.