Registration Form

AFTER YOU FILL IN THIS FORM, REMEMBER TO CLICK ON THE "REGISTER" BUTTON AT THE BOTTOM OF THE PAGE

Fields marked with (*) are compulsory

Conference Details*

This form allows you to apply for both the Harley Wood Summer School and the ASA 2005 Conference. (The Harley Wood Winter School is for students and invited speakers only.) Please indicate which conference(s) you wish to attend:
ASA 2005 Only
Harley Wood Winter School Only
Both ASA Conference 2005 and Harley Wood Winter School

Personal Details

Title*:
First Name*:
Middle Initial:
Surname*:
Level of ASA Affiliation (eg. member, fellow, student member, non-member, retired member)*:
Institute*:
Postal Address (line 1)*:
Postal Address (line 2):
Postal Address (line 3):
Country*:
Postcode*:
Email*:
Phone*:
Fax:

ASA 2005

ASA Registration Fee:

ASA Conference Dinner Guests are accepted at a cost of $90 per guest. ***NO LONGER AVAILABLE***

Number of people attending the conference dinner:

Are there any special dietary requirements you wish to make us aware of:

Please indicate if you expect to attend the reception on Sunday evening:

Presentations at the ASA 2005 Conference

***PRESENTATIONS ARE NOT ACCEPTED ANYMORE***

Applications to contribute posters or talks at the ASA Conference are encouraged. We will try to accommodate all requests for talks, but if there are insufficient timeslots, some requests for a talk may be assigned to a poster session. (If you wish to make multiple contributions please e-mail the details as requested below to asa2005@physics.usyd.edu.au).

I wish to present:
Presentation title:
Abstract (please don't use double quotation marks; latex symbols are accepted, max. 300 words):

Any special requirements (video playback etc.):

Harley Wood Winter School

Harley Wood Winter School Registration Fee:

HWWS Dinner Guests are accepted at a cost of $35 per guest.

Number of people attending the HWWS dinner:

Are there any special dietary requirements you wish to make us aware of:

Payment Details

Please organise payment immediately after registration. (All prices stated include GST)

Calculate total payment, i.e. registration + any additional guest activities (Requires a Javascript compatible browser. If it doesn't work, don't worry as the totals are confirmed on the next page.)

Registration cost (AUD$):
Guest activities cost (AUD$):
Total payment (AUD$):

N.B. All guest activities will appear on a separate personal invoice.

Payment by Department Invoice

Until May 15 2005 we are able to directly invoice conference registration fees to your department (if required). To use this method of payment, once you have all completed and submitted this web registration form please email asa2005@physics.usyd.edu.au with a full list of all members of your department to be included on this invoice, who to make the invoice out to, and a full postal address.

I wish to pay by Department Invoice:

If you have elected to be invoiced directly through your department but have requested any guest places please ensure the 'other payment' section is also completed as you must pay for guest places personally.

Other Payment

Payment can be in the form of credit card (VISA, Mastercard or Bankcard), cheque (made payable to ASA Annual Science Meeting), or direct deposit.

Other payment method:

If you are paying by credit card, please print this form, fill in your credit card details and fax it to "ASA Conference 2005, c/o Daniel Mitchell" on 02 9351 7726:

Name on Card:

Card No:

Expiry date:

Type of card (e.g. Visa, Mastercard etc.):

Payment Amount:

Card holder's signature:

If you are paying by cheque, please post a cheque made out to "ASA Annual Science Meeting" to:

ASA Conference 2005
c/o Daniel Mitchell
School of Physics
The University of Sydney
NSW 2006
Australia

If you are paying by direct deposit, please deposit the money in the account:

Account name: ASA Annual Science Meeting
BSB No.: 062284
Account No.: 1024 2214

and in the "comments" section of the web form used for the transfer, include your name. This is required so that we know where the money comes from.

Additional Information

Parking: parking vouchers for the University campus are available at the cost of $6 per day. These must be paid for at the registration desk at the conference. Please indicate how many one-day vouchers you require.

Any further requirements, comments ... ?

Finally, please remember to book your own accommodation.