The Australian Mars Exploration Conference

REGISTRATION FORM


Name ______________________ E-Mail Address_______________________


Postal Address __________________________________________________


City _____________________ State _________ Postcode______________


Phone (______) ___________________   [ ]Home  or  [ ]Work ?

CONFERENCE REGISTRATION fee tick one

Full $60 [___]

Concession/Student $45 [___]

Full Mars Society Member $45 [___]

Concession Mars Society Member $30 [___]

CONFERENCE BANQUET (optional)
7.30pm Saturday 12 May, venue to be announced.
Tick here [__] for vegetarian menu.
$60 optional
[___]

MARS SOCIETY MEMBERSHIP (optional)
If you are not already a member of the Mars Society
join now to qualify for the membership discount
by signing below:

I wish to become a member of the Mars Society Australia.

______________________________ _________ Signature Date
optional

Family $50 [___]

Regular $40 [___]

Student $25 [___]

TOTAL
$_____

Pay by money order or cheque (make cheques to 'The Mars Society Australia').
Please print and fill out this form, then send it with payment enclosed to:

  AMEC Registrations
  PO Box 151
  CLIFTON HILL 3068

CONFERENCE REGISTRATION	fee	tick one
Full	$60	[___]
Concession/Student	$45	[___]
Full Mars Society Member	$45	[___]
Concession Mars Society Member	$30	[___]
CONFERENCE BANQUET (optional) 7.30pm Saturday 12 May, venue to be announced. Tick here [__] for vegetarian menu.	$60	optional [___]
MARS SOCIETY MEMBERSHIP (optional) If you are not already a member of the Mars Society join now to qualify for the membership discount by signing below: I wish to become a member of the Mars Society Australia. ______________________________ _________ Signature Date		optional
Family	$50	[___]
Regular	$40	[___]
Student	$25	[___]
TOTAL	$_____