23rd Australasian Joint Conference on Artificial Intelligence: AI 2010

University of South Australia, Adelaide, 7-10 December 2010

REGISTRATION FORM
This is a tax invoice
ABN 37 191 313 308
Please complete a form for each participant
Please regard this registration form as a
conference offer. Upon the appropriate amount
this registration form will become a Tax
Invoice. Please keep a copy of this form for
taxation purposes.
Section 1: Personal information

Title ________ Given name_______________________________ Family name________________________________

Preferred name for name tag ________________________________________________________________________
School / Institution / Organisation _____________________________________________________________________
Mailing address _________________________________________________________________________________
Suburb/Town ________________________________________ State________________________________________
Postcode __________________________________ Country_______________________________________________
Email address ____________________________________________________________________________________
Phone ___________________________________________ Fax ___________________________________________

A list of conference participants will be published. If you do NOT wish your name to be published please tick this box 
Section 2: Registration fees

All costs are quoted in Australian dollars (AUD) and include the Australian Goods and Services tax (GST).
Cost includes attendance, conference satchel, CD of conference proceedings, program and abstracts, lunches, morning
and afternoon teas, and conference banquet.
full registration student registration
 $750 AI 2010  $450 AI 2010 (no banquet)
 $300 workshop only  $150 workshop only
 $850 workshop + AI 2010  $500 workshop + AI 2010
To qualify for the student rate you must be currently enrolled as a full time student and provide the following information
Institution _______________________________________________ Student ID number ________________________

If you are an author, paper ID __________ title __________________________________________________________

If you register workshop, workshop name __________________________________________________________

Conference dinner Please tick box if attending

 Full registrants (no fee)  Guests $100.00
If more than one guest attending please indicate number __________________
Please list any special dietary requirements ____________________________________________________________
Cancellation policy: A charge equivalent to 20% of the appropriate fees will be applied. After 1 November 2010, no
refund will be allowed.

Section 3: Payment details

All payments must be made in Australian dollars (AUD)

Please debit my Mastercard  Visa 

Card number ___ ___ ___ ___ / ___ ___ ___ ___/ ___ ___ ___ ___/ ___ ___ ___ ___
Name on card _______________________________________________ Expiry date __________________________
Signature___________________________________________________ Amount _____________________________

Fax the form to +61 8 83023988 or

Send a scanned copy to Ivan.Lee@unisa.edu.au