REGISTRATION PAGE



Heritage Hotel Queenstown
August 7th, 8th, 9th, & 10th, 2008

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Register early as numbers may be limited
due to capacity of venue



ONLINE FORM


*Fields marked with an asterisk (*) MUST be completed to send form!

Title:
* First and Last Name
* E-Mail address:
* Telephone Number:
* Qualifications:
* Department:
* Hospital/Centre:
* State/Province:
* Country:
* Address:
Facsimile Number: 
Companion's Name:


* Registration Fees (Please tick all that apply)
$AUD 745.00    - Full Registrant - Perfusionist¹
$AUD 600.00    - Subsidised Registrant - Student Perfusionist¹
$AUD 745.00    - Full Registrant - Scientist/ Surgeon/ Anaesthetist/ Nurse/ Allied Health¹
$AUD 495.00    - Companion Registration ²
NB: All registrations received after 12th July 2008 will be $AUD845.00


* Will you be attending Sponsored Activity? ($AUD 50.00 per person)
Yes   No   Two People  
 (Subsidised by Cellplex Pty Ltd)

1 Registration fee includes Thursday Night - welcome function and dinner / Friday - breakfast, lunch & cocktail party dinner / Saturday - breakfast, lunch & formal dinner / Sunday - breakfast
2 Registration fee includes Thursday Night - welcome function and dinner / Friday - lunch & cocktail party dinner / Saturday - lunch & formal dinner
Payment Information
** Payment by Cheque:
(Please send cheque within 7 days or online application will be invalid!)

Cheques in Australian Dollars and made payable to:-
"Perfusion Downunder Pty Ltd"

Payment by Credit Card:
Visa Mastercard
Card Number:
Expiry Date:
  Month/Year
Name on Card:



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** Post cheques to:-
Bernardette Tackney, Cellplex Pty Ltd,
16-18 Hydrive Close, Dandenong South, VIC 3175
Fax No. +61 3 9799 7111, Telephone +61 3 9799 7444
E-mail: btackney@cellplex.net
Registrations may be limited due to capacity of the venue. Registrants must be primary practising clinicians. The Organising Committee reserves the right to accept or decline applications for registration.


Go to Points allocation page > > >
  • ABCP
  • ANZCA

  • ANZCP
  • EBCP
  • RACS
  • SOPGBI
  • recertification CEU's awarded - 16.5 under category 1
  • Meeting/Didactic sessions: Category 1/Level 1: 1 Credit per hour Workshops (with no practical skills learning): Category 1/Level 2: 2 Credits per hour.
  • recertification Points awarded 10
  • approval for 8 recertification points.
  • 8 CPE points have been awarded.
  • approved for 17 points in Category 4: Maintenance of Clinical Knowledge and Skills.   Workshops (with no practical skills learning): Category 1/Level 2: 2 Credits per hour


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2008
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