Professional Documents
Culture Documents
CPD 2014
DATE
$236.00 (inc GST) Limit: 80 (includes light lunch & afternoon tea)
CONVENOR
A multiple course Registration Form may be downloaded from the ADA website at www.adawa.com.au in the CPD area.
Course Date:
Title: (Prof/Dr/Other) Given Name: Surname: Postal Address: State: Work Phone: Email Address: Additional Participants: (Names) Payment: Total Amount: $
Credit Card: Mastercard Visa
(includes GST)
Postcode:
Mobile Phone:
Please Note: Non ADA Members add 50% to course fee (members of other ADA branches exempt)
AMEX Diners
Card Number: Cardholder Name: Fax completed form to ADA WA Branch (08) 9321 1757
Cheque: Make cheque payable to ADA WA Branch Inc and post to PO Box 34, West Perth WA 6872 with your Registration Form.
No Certicate of Attendance will be issued. A receipt/tax invoice will be provided showing the course name and CPD hours for your records. Bookings, Course & Payment Enquiries: ADA Oce (08) 9211 5600. Other enquiries: Dr Jenny Ball 0419 044 549. Please note: Your registration for these events indicates acceptance of the CPD Terms and Conditions contained in the ADA WA CPD 2014 Course Book.