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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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