Fillable FUTORES II Manual Registration Final (James Cook University of North Queensland)

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FUTORES II Manual Registration Final (James Cook University of North Queensland)

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Page 1
FUTORES II – Future Understanding of Tectonics, Ores, Resources,
Environment and Sustainability
4-7 June 2017
Townsville,
Queensland, Australia
MANUAL REGISTRATION - DELEGATES
Delegates are requested to complete this form, if they are unable to register online, then print and sign to authorise credit card
payment. Please email the completed form to EGRU@jcu.edu.au. Enquiries may be forwarded to EGRU@jcu.edu.au or by
phoning EGRU Administration on +61 (7) 4781 4726.
James Cook University recognises the Importance of protecting your personal and sensitive information and is bound by the
Privacy
Amendment (Private Sector) Act 2000. This information contained in this form will not be disclosed to third parties.
*If registering as a student, please include a scan of your current student identification card when submitting your registration.
CONFERENCE ATTENDANCE
Early Bird registration closes 31 March 2017. Standard registration applies from 1 April 2017.
Category Price Selection Category Price Selection
EGRU Member $660 EGRU Member $715
Non Member $825 Non Member $935
Student* $440 Student* $490
Day Rate $385 Date Rate $385
Accompanying Person $250 Accompanying Person $250
SOCIAL EVENTS
Icebreaker Included in your registration fee.
Please indicate if you will be attending:
Additional Icebreaker $50 each Number of tickets:
Conference Dinner $125 each Number of tickets:
WORKSHOPS
Workshop 1 – Skarn Deposits (3 June) Workshop 2 – Geology of Australia (3 June)
EGRU Member $440 EGRU Member $440
Non Member $550 Non Member $550
Student $225 Student $225
Workshop 3 – Structural Geology in Epithermal Systems
(4 June)
Workshop 4 – Porphyry-epithermal Cu-Au deposits
(4 June)
EGRU Member $440 EGRU Member $440
Non Member $550 Non Member $550
Student $225 Student $225
Workshop 5 – Leapfrog 3D (2-4 June)
EGRU Member $1,100
Non Member $1,450
Student $725
Please select
FUTORES II – Future Understanding of Tectonics, Ores, Resources,
Environment and Sustainability
4-7 June 2017
Townsville, Queensland, Australia
REGISTRATION FOR CHINESE DELEGATES
Page 2
FIELD TRIPS
Field Trip 1 – Mt Carlton-Ravenswood-Charters Towers
(8-10 June)
Field Trip 2 – Mt Garnet-Chillagoe-Wolfram Camp
(8-11 June)
Individual $990 Individual $1,300
Student $495 Student $650
DELEG
ATE INFORMATION
First Name Surname
Company Name /
Affiliation
Your Position
Email Address Mobile/Cell Phone
Country Address
Suburb/City State Post/Zip Code
PREFERENCES
Please include my name in the conference participant list
Preferred name for conference badge
Are you an EGRU Member?
Are you a student? Please include a scan of your student card
Are you JCU Alumni?
Dietary preferences
No special request Dairy free Gluten free
Halal Lactose intolerant No seafood
Vegan Vegetarian
Other – please advise:
Please select
Please select
Please select
Please select
FUTORES II – Future Understanding of Tectonics, Ores, Resources,
Environment and Sustainability
4-7 June 2017
Townsville, Queensland, Australia
REGISTRATION FOR CHINESE DELEGATES
Page 3
BILLING INFORMATION
Same as above
Email
Phone
Country
Address
Suburb/City State Post/Zip Code
BILLING INFORMATION
Please note, James Cook University accepts Mastercard or Visa payments only.
I/we authorise James Cook University to charge the following credit card for the amount:
Name on Card
Card Number
Expiration CSC
Signature
Please email the completed form to EGRU@jcu.edu.au.
Month
Year
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FUTORES II Manual Registration Final (James Cook University of North Queensland)

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Completed 20 July 2020

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