REGISTRATION FORM

4th Australian and New Zealand Stata users Group meeting and Workshops

    General Stata Users Group Meeting only
            (Saturday 17th September 2011)
            Price: $90

    Workshop - Survey Data Analysis with Stata
            (Sunday 18th September 2011)
            Price: $A110




The Total for this purchase $A:




    Restaurant Meal after General Stata Users Group Meeting -
            (Saturday 17th September 2011) please check box.
if you would like more details later            


Purchasers details


  First Name: *  

  Last Name: *   

  Address: *      

  Suburb: *              


  State/New Zealand: *           

  Postcode: *    

   Phone: *           
  Please include area code

   Email: *            






Payment details


      EFT (Electronic fund transfer)

      Credit Card -- Visa or MasterCard - Number given over the Phone
      Credit Card - - Visa or MasterCard - Number sent by Mail
      Credit Card - - Visa or MasterCard - Number sent by Fax

      Cheque - Sent by mail



EFT
    You can make direct debit payments to our cheque account at any branch of Westpac or by online banking with a "pay anyone" transfer.
    Please include your NAME with the payment, so that your payment can be identified.
    We will process your order as soon as we see your NAME against a payment on our bank account.
        Our bank details are:
        Account name: Survey Design and Analysis Services Pty Ltd
            BSB:        033 050
            Account number:    143 027


Credit Card:
- Visa or MasterCard -
    Phone through your credit card details     (03) 9878 7373
        or

    Print order form after having pressed submit and include credit card details on the page.
    This can be mailed to:
      Survey Design and Analysis Services
          P.O Box 1206
          Blackburn North VIC 3130

        or
        Fax to: 03 9878 2345


Cheques
    Please make payable to Survey Design and Analysis Services Pty Ltd. Cheques should be in Australian dollars drawn     on an Australian bank. Post to:
      Survey Design and Analysis Services
      P.O Box 1206
      Blackburn North VIC 3130








Contact

Survey Design and Analysis Services
Contact: Karl and Helen Keesman
P.O Box 1206
Blackburn North VIC 3130
Fax 03 9878 2345
Phone 03 9878 7373
Email: sales@survey-design.com.au