Registration Form 
Web Accessibility Workshop (less technical) - Sydney
 Wednesday 5th October 2005, 9am-5pm
Green Room, Wesley Conference Centre, 220 Pitt Street
Please complete this form, then print it out and mail or fax with your payment to:  

Web Accessibility
National Information & Library Service
(A subsidiary of RBS.RVIB.VAF Ltd, formerly Royal Blind Society of NSW, Royal Victorian Institute for the Blind and Vision Australia Foundation)
454 Glenferrie Road, Kooyong VIC 3144,
Fax: 03 9864 9370; Phone: 03 9864 9600

The National Information & Library Service may use your details to contact you in future about Web accessibility issues. If you do not want to receive such information please tick the Box:

|__| - I do not want to be contacted about other Web accessibility issues after this Workshop 

Attendee's Name:		

Position Title:		

Company/Organisation:		

Address:	………………………………………………………

	………………………………………………………

Phone (W)………………………………Mobile	

Fax: 		

Email:		

Web address of the site you maintain or are involved with  
(to assist in planning for the session)

URL:   	http://	

NB. Please complete one registration form per attendee.

Enquiries:	Tania Conlan Ph 03 9864 9249
Tax Invoice
National Information and Library Service
ABN:  73 094 583 874; ACN:  094 583 874

Web Accessibility
National Information & Library Service
(A subsidiary of RBS.RVIB.VAF Ltd, formerly Royal Blind Society of NSW, Royal Victorian Institute for the Blind and Vision Australia Foundation)
454 Glenferrie Road,
Kooyong VIC 3144,
Fax: 03 9864 9370; Phone: 03 9864 9600

Invoice Date:	16th June 2004
Event:	Web Accessibility Workshop, Sydney – 5th October 2005

Attendee Name:	……………………………………………………………….

Company/Organisation:   …………………………………………………………

Registration Fee:	$522.50 including GST ($47.50)
AIMIA Members:	$495.00 including GST ($45.00) 

AIMIA Membership number: ……………………………………

1.	I enclose a Cheque for $522.50 / $495.00 payable to National Information & Library Service 

2.	Please charge $522.50 / $495.00 to my   Bankcard    VISA    MasterCard  
[NB. AMEX/Diners are NOT accepted]

Card Number (16 digits):

Expiry Date:	|__|__|  |__|__|  

	Name on Card:		

	Signature:		

I have read and understand the registration, cancellation, and refund conditions available on the web site and agree to abide by their terms.

Name:		 ______________________________

Signature	_______________________________

Date:		 __ __/__ __/ __ __

Workshop details are available from: http://www.nils.org.au/ais/
NOTE: Please return your Registration Form by fax asap.
Your application will be finalised when payment is received.