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Round Table on Information Access
for People with Print Disabilities Inc.
2010 Annual Conference:
Think Globally, Act Locally!
Conference Registration Form
Sunday 23rd to Tuesday 25 May 2010
Auckland, New Zealand
Venue: Heritage Auckland
35 Hobson Street, Central Auckland
Phone: +64 9 379 8553
Fax: +64 9 979 7540
Conference Payments, Enquiries and Registrations:
Conference Registrations close on Friday 9 April 2010.
Please send Conference Registration Form and Payment by 9 April 2010 to
Tammy Axelsen, Administrative Officer
Round Table on Information Access for People with Print Disabilities Inc
PO Box 229, Lindisfarne Tasmania 7015, Australia.
or
Email roundtableadmn@
Fax: +61 3 6265 1519
Ph: Mobile +61417 101 418
Visit Round Table at e-.au/roundtable/
and the conference blog at roundtable2010.
Round Table on Information Access for People with Print Disabilities Inc.
ABN 64 941 990 153
Conference Registration Form & Tax Invoice
2010 Round Table Annual Conference, Auckland, New Zealand
Section 1: Personal Details – Please Print
Title (Mr/Mrs/Ms/Dr/etc): ____________
Name: ____________________________________
Name for Conference Badge: ____________________________________
Organisation: ____________________________________
Mailing Address: ____________________________________________________________
Telephone: ________________________
Mobile: ________________________
Fax: ________________________
Email: ____________________________________
Format requirements
Conference information will be supplied in accessible electronic formats on a USB stick. Conference programmes will be available from the venue in print, large print and braille. Please indicate if you require conference information in another format. Place an X between the brackets [ ] to indicate your requirement:
[ ] Braille
[ ] Large print
Accessibility requirements
Please indicate your requirements by placing an X between the brackets [ ]
[ ] Audio induction loop
[ ] Wheelchair access
[ ] Venue Orientation
[ ] Other: ____________________________________________________________
[ ] Guide Dog? If yes, name of Guide Dog: ________________________
Special dietary requirements
Please indicate any special dietary requirements: ____________________________________________________
Section 2: Conference Fees
(all fees are in Australian dollars)
Conference Registration Fees
Please note:
• All conference registration fees are quoted in Australian Dollars.
• Fees include New Zealand GST of 12.5%
• Fees do not include Australian GST
Full Conference (3 days)
Round Table members: AU$330
Non-Round Table members: AU$420
or
Selected days (Sunday/Monday)
Round Table members: AU$130 per day
Non-Round Table members: AU$150 per day
Tuesday (includes lunch)
Round Table members: AU$95
Non-Round Table members: AU$105
Places are available for self-funded individuals with a print disability at the concession rate of AU$62 per day.
Please indicate which days you will be attending. Place an X between the brackets [ ] to indicate your attendance:
[ ] Full conference (please indicate specific workshops listed below)
Or
[ ] Sunday 23rd May.
[ ] Monday 24th May
[ ] Tuesday 25th May
Total Registration Cost $________________________
Please indicate whether you will be attending the Round Table AGM:
[ ] Attending Round Table AGM (Tues)
Optional Pre-conference Tours (Saturday 22 May)
Pre-conference tours are being held on Saturday the 22nd of May. There is no cost for these events. Transport is the responsibility of the delegate. Further information about transport options will be advised closer to the tour date.
|Time |Event |Location |
|1.00-2.30pm |Auckland City Libraries: accessible tour of the Central City Library, presenting and |Central City Library, Lorne Street, |
| |considering current and future services for print-disabled borrowers |Auckland |
|4.00-6.00pm |Royal New Zealand Foundation of the Blind: tour of library and accessible format |RNZFB Awhina House, 4 Maunsell Road, |
| |production facilities. (late afternoon) |Parnell |
|6.00pm |Social event (details TBA) |RNZFB Awhina House, 4 Maunsell Road, |
| | |Parnell |
Please indicate if you are intending to participate in these events. Place an X between the brackets [ ] to indicate your attendance:
[ ] Auckland City Libraries.
[ ] Royal New Zealand Foundation of the Blind.
[ ] Social event.
Section 3 Conference Dinner - Sunday 23rd May 2010
The Conference Dinner will be held at Pastis, 128 Victoria St West, Auckland Central Sunday 23rd May 2010 at 7:00pm. Cost AU$48 per person. (All beverages to be purchased individually).
Pastis is a short walk from the conference venue, and is a Parisian-style bar and brasserie. Conference Dinner is a three course set menu with two or three options in each course. Vegetarian options and special dietary requirements will be catered for on request.
Place an X between the brackets [ ] to indicate your preference:
[ ] I will be attending the Conference Dinner.
[ ] I will be accompanied to the dinner by ___________________________________________
[ ] I require a vegetarian meal
[ ] I have special dietary requirements: _____________________________________________
Section 4 Payment Summary
|Section 2 |Registration Fees |AU$ |
|Section 3 |Conference Dinner |AU$ |
| |PAYMENT TOTAL ($AUS) |AU$ |
If making one payment for multiple delegates from the same organisation please staple registration details for EACH delegate (pages 2-5) to this Payment Summary sheet and list the delegates below. Each delegate is required to sign the declaration at the bottom of page 9.
Please note
• Conference registrations and the conference dinner must be paid before the conference date.
• All registrations and charges are to be paid in Australian dollars to the Round Table office, PO Box 229, Lindisfarne, 7015 Tasmania, Australia.
• The conference registrations do not contain Australian GST. Australian GST is not payable nor claimable.
• All conference payments including accommodation contain New Zealand GST at the rate of 12.5%.
• Conference accommodation charges are not to be paid to the Round Table and must be paid direct to the accommodation provider.
• Exchange rate variances and charges are the responsibility of the attendees and no responsibility for currency matters are accepted by the Round Table.
Declaration
Permission to Share Contact Details
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.
Name: ________________________________________________
Signature: ________________________________________________
Date: ________________________
Payment Options
Please select one of the following options.
Place an X between the brackets [ ] to indicate your preference:
[ ] 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.
Swift Code: NATAAU3303M (where applicable for overseas transfer)
BSB Number: 083 522
Account Number: 45 742 1243
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@ or by mail to the address on page 1 of this form.
[ ] Credit Card - We are only able to accept charges to Visa or Mastercard credit cards
Credit Card Authorisation
Card Type: Place an X between the brackets [ ] to indicate the type of card:
[ ] Visa
[ ] Mastercard
Card Number: ____________________________________
Expiry Date: ________________________
Cardholder Name: ________________________________________________
Cardholder Signature: ____________________________________
Amount: ________________________
Round Table on Information Access for People with Print Disabilities Inc.
ABN 64 941 990 153
Round Table
Tax Invoice
This document will be a Tax Invoice when you make payment.
2010 Conference Expenses
Name: ____________________________________
Organisation: ____________________________________
|Conference Registration |$AUS____________ |
|Conference Dinner |$AUS____________ |
|TOTAL |$AUS____________ |
This total does not include an Australian GST component.
This total includes 12.5% New Zealand GST.
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
Lindisfarne
TAS 7015
Australia
Email: roundtableadmn@
Fax: +61 3 6265 1519
Ph: +61 417 101 418
Accommodation
Please book your own accommodation directly with the Heritage Hotel by 9 April 2010. Refer to the separate booking form.
Booking Details
Please use the separate booking form to reserve accommodation at the Heritage Auckland.
For queries about accommodation, contact the hotel directly.
Phone: Jody Sharratt on +64 9 979 7591
Email: res@heritagehotels.co.nz
Quote "Round Table on Information Access for People with Print Disabilities conference"
The rates negotiated for the conference are listed below.
All rates are in New Zealand dollars.
NZ$155 per night - Superior Room Only - single or twin share
NZ$177 per night - Superior Room + 1 Buffet Breakfast
NZ$329 per night - Two Bedroom Suite - Room Only
Additional breakfasts at the special rate of NZ$25 per person
Please notify the staff at the Heritage Hotel of any special needs at the time of booking.
In order to ensure room availability and to access the special rates, bookings must be made direct with the hotel by 9 April 2010. The special rate cannot be guaranteed after this date. All bookings subject to availability.
Parking
Valet car parking is available on-site at the hotel at a rate of $25 (New Zealand) per day.
Conference Proceedings
Conference proceedings will be available on the Round Table website following the conference.
Website: roundtable
Conference blog: roundtable2010.
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