Exhibition Registration Form - ITS Australia

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Australian Intelligent Transport Systems Summit 2013
Exhibition Registration Form
This electronic document has been made interactive for your immediate use. To secure your exhibition requirements at the Australian
Intelligent Transport Systems Summit 2013, please fill in the appropriate form fields then hit the SUBMIT button and follow the prompts.
If you wish to print and manually complete this document please fax it to ITS Australia on (03) 9646 5066.
RSVP by COB June 30th 2013 as additional charges will occur for registrations after this date.
EXHIBITOR Details:
Company name:
Company address:
Name of primary representative & ticket holder:
Email: Tel: Mob:
Name of secondary representative & ticket holder:
Email: Tel: Mob:
Preferred booth number(s) (subject to availability):
Please refer to page 9 of the ‘Sponsorship and Exhibition Opportunities’ brochure for the exhibition floorplan.
Furniture package CHOICE (please select one only):
Please refer to page 8 of the ‘Sponsorship and Exhibition Opportunities’ brochure for further information on furniture packages.
Option 1: 1 x lockable curved counter/cupboard, 2 x stools
Option 3: Mode round dry bar, 3 x stools
Option 2: Mode round meeting table, 3 x Chairs
Option 4: 2 x ottoman cubes, 1 x bench seat, 1 x oblong coffee table
Requirements:
Item qTY PAYABLE
Early bird booth payment (up to and including June 30th) $5,500 +gst each $
Standard booth payment (after June 30th) $6,600 +gst each $
40” plasma screen(s) $800 +gst each $
Total Amount Payable $
Payment details:
Please note that a tax invoice/receipt will be issued only on request.
Direct Deposit:
I will deposit the fee directly into the ITS Australia bank account and I will submit this form electronically or fax it to +61 (0)3 9646 5066.
Bank: Commonwealth Bank Account Name: ITS Australia BSB No.: 062-919 Account No.: 1012 8532
Cheque:
I will post a cheque (made payable to ITS Australia) and this registration form to:
Australian ITS Summit 2013, Suite 23/574 Plummer Street, Port Melbourne VIC 3207
Credit Card:
Please charge my Credit Card and I will submit this form electronically or fax it to +61 (0)3 9646 5066.
Visa MasterCard
Card Number:
Card Name:
Signature:
(Please complete if you are manually completing this form)
Card Expiry: ______ /______
I authorise this transaction
(Please tick box if you are completing this form electronically)

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Australian Intelligent Transport Systems Summit 2013
Exhibition Registration Form
Cancellation Policy:
Cancellations are to be received in writing. 50% refund will be paid for cancellations received more than 7 days prior to the event.
No refund will be paid for cancellations received 7 days or less prior to the event.
Once this interactive form has been completed, please verify information given is correct, and
SUBMIT THIS FORM 8
If you wish to print and manually complete this document please fax it to ITS Australia on (03) 9646 5066.
RSVP by COB June 30th 2013 as additional charges will occur for registrations after this date.
Intelligent Transport Systems Australia Incorporated ABN 24 090 235 493 Suite 23/574 Plummer Street, Port Melbourne VIC 3207
Phone: +61 (0)3 9646 6466 Facsimile: +61 (0)3 9646 5066 Email: admin@its-australia.com.au