APTTA Convention and Piano Expo 2019 Registration

Sponsor Staff Registration

ABN: 14 974 207 301
If you cannot pay by credit card, please print the form in the PDF registration form. Return to Conference web page

Printed PDF copies of the ONLINE Form will not be accepted.
This form requires a Credit Card Payment. For other forms of payment, please download the PDF version.

Please complete all sections coloured RED.
Personal Details
*Required fields
*Title:
*Given name:
*Surname:
*Organisation:
*Address:
*City/Suburb
*State/Province/County:
*Postcode
Country
*Telephone (BH)
Mobile/Cell
*Delegate e-mail address
*Confirm e-mail address
Badge Name (if different from above)
Special Dietary Requirements
Other Special Needs or Requirements
Partner Details
(Required for social events if applicable)
Full name including title
Special or Dietary Requirements
*I have a partner who is interested in the Partners Program:

Tax Invoice Details (if different from above)
Contact Person Full Name:
Tax Invoice e-mail address
Confirm e-mail address
Telephone
Note: If Tax Invoice details are not supplied
the delegate is responsible for passing on all relevant documents.

Welcome Reception
Tickets cost $55 per person
Are you attending the Welcome Reception?
 

Friday Dinner
Are you attending the Friday Dinner?
Dinner tickets cost AUD$80 per adult, $40 per child
 

Goona Warra Winery Formal Dinner
Cost: $110/person.
Includes: Return coach transfer to Goona Warra Winery, 3 course meal including entrée, main, dessert, freshly brewed tea and coffee, Goona Warra drinks package and entertainment.
Are you attending the Winery Dinner?
 

Accommodation
Room rates are per room per night
(rooms subject to availability)
 
Arrival date: Click to pick date (please insert arrival date)
Departure date: Click to pick date (please insert departure date)
 
Please select hotel and room:

Hyatt Place Hotel Melbourne

King Room @ $255 per night
Mountain View King Room @ $270 per night
Limited rooms - strictly subject to availability.
City View King Room @ $270 per night
Limited rooms - strictly subject to availability.
2 x Standard Queen Rooms @ $320 per night
Limited rooms - strictly subject to availability.
Total Nights Required:
Sharing room with nominated partner
Full name of other person/s sharing room (if not partner):
Special accommodation requirements:

Total Payment Summary
All payments to be made in Australian Dollars
Welcome Reception @ ($55 p/p):AUD$
Conference Dinner (Friday) @ ($80 p/a, $40p/c):AUD$
Winery Dinner (Saturday) @ ($110 p/p):AUD$
Accommodation:AUD$
Other:AUD$
Please specify reason for 'Other':
Total Amount:AUD$
Notes:
Privacy:
I do NOT want to be listed on the conference delegate list
In compliance with the Privacy Act 2001 please indicate with a tick if you do not want your name and organisation details to be published in a conference delegate list for distribution to conference delegates.

Credit card payment information
Mastercard and Visa Only
Please note: this form sends the card details to conference organisers via secure means. It does not charge your card immediately. All details and amounts are confirmed and checked by the conference organisers prior to charges against the credit card.
Cardholder's name
Card number
Card expiry
CVV
Total to chargeAUD$
* Required. I understand that by paying by credit card the following the following will appear on my bank statement: 'AM MEETINGS PLUS P L MOONEE PONDS'. A $220 fee may apply if a transaction I have authorised A.M. Meetings Plus to charge as payment to attend this conference/event is reversed or queried without warning once it has been approved, processed and receipted.
 

On submission of this form a summary of your booking will appear.
Please print for your records.

Please complete highlighted fields.
Note that the submission button will not appear
if compulsory fields are not completed.

 

Contact Details & Enquiries:

A.M. Meetings Plus Pty Ltd
Professional Conference Management

Phone: 03 9372 7182 (International +61 3 9372 7182)
Email: aptta19@ammp.com.au
© Copyright - 2019, A M Meetings Plus Pty Ltd