Australex 1999 Conference Registration Form

REGISTRATION FORM for AUSTRALEX 1999

Australex Conference 1999, 30 October 1999, ANU, Canberra

PERSONAL DETAILS (BLOCK LETTERS PLEASE)

Name (Last/First): .......................................................

If registering as a student, Student Number: .............................

Mailing address (please give institutional address if possible, including
Postcode and Country):
..........................................................................

..........................................................................

..........................................................................

Ph (Work): ............................ (Home): ..........................

Facsimile: ...............................................................

* E-mail: ................................................................
* (this is the preferred method of correspondence)

Badge Details:
Preferred First Name: ....................................................

Institution/Company: .....................................................

   [ ]  I require information on child care

Accommodation at ANU
We ask you to arrange your own accommodation, but if you need help, state for which nights:

[ ] 29 October 1999 [ ] 30 October 1999

Make cheque payable in A$ to "Australex". (Sorry, no credit
cards.) Send $30 payment and registration form to:

Bruce Moore (Treasurer)
Australian National Dictionary Centre
Australian National University ACT 0200
Bruce.Moore@anu.edu.au +61 6 249 2615

Australex 1999 conference page

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