ACP2010RegistrationB.. - Conference Matters

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REGISTRATION FEES - All rates shown in NZ DollarsBASIC & ADVANCED PHLEBOLOGY COURSESSat 06 - Sun 07 FebEarly Bird Registration Regular Registration Late RegistrationPrior to 14 December After 14 DecemberOnsiteBasic/Advanced Course $770 $990 $1100ACP Basic/Advanced Trainees FREE FREE FREEUniversity Students FREE FREE FREEDiscount if registered for Conference -$220 -$220 -$220ANNUAL SCIENTIFIC MEETING (3-DAYS) - Includes Conference Welcome Party, Conferring Ceremony & Gala DinnerMon 08 Feb - Wed 10 FebEarly Bird Registration Regular Registration Late RegistrationPrior to 14 December After 14 DecemberOnsiteACP Fellows and Medical Members $1,200 $1,430 $1,540Non-member Medical $1,430 $1,540 $1,650ACP Affiliate Members (Sonographers,Nurses, Scientists, Student Members)$770 $990 $1100Non-member Sonographer, Nurse Scientist, andMedical/ Sonography/ Nursing/ Science Student$990 $1100 $1,100ACP Basic/Advanced Trainees $770 $990 $1100DAILY REGISTRATIONDaily RegistrationEarly Bird Registration Regular Registration Late RegistrationPrior to 14 December After 14 DecemberOnsiteACP Fellows and Medical Members $440 $550 $660Non-Members $550 $660 $770University Students* FREE FREE FREEACP Affiliate Members $330 $440 $550ACP Basic/Advanced Trainees $330 $440 $550DIAGNOSTIC IMAGING SONOGRAPHY WORKSHOPThurs 11 FebEarly Bird Registration Regular Registration Late RegistrationPrior to 14 December After 14 DecemberOnsiteACP Fellows and Medical Members $660 $770 $880Non-member Medical $770 $880 $990ACP Affiliate Members (Sonographers,Nurses, Scientists, Student Members)$330 $440 $550Non-member Sonographer, Nurse Scientist, andMedical/ Sonography/ Nursing/ Science Student$660 $770 $880ACP Basic/Advanced Trainees FREE FREE FREEUniversity Students FREE FREE FREEDiscount if registered for Conference -$110 -$110 -$110ADDITIONAL REGISTRATIONSat 06 Feb - Thurs 11 FebEarly Bird Registration Regular Registration Late RegistrationPrior to 14 December After 14 DecemberOnsiteInternational and Keynote Speakers Complimentary Complimentary ComplimentaryComplimentary Day Complimentary Day Complimentary DayInvited Speakers & the local scientific facultyregistration for the day of registration for the day of registration for the day ofpresentation. Full fees for presentation. Full fees for presentation. Full fees forother days and sessions. other days and sessions. other days and sessions.Other Presenters Full fees as above Full fees as above Full fees as above* University Students: Does not include conference dinner. All students must have their applications endorsed by their Professor or Head of Department and have to send in a copy of their student ID-card.REGISTRATION ENTITLEMENTSBasic Phlebology Course (Phlebology Part I)Entry to Basic or Advanced Course on Saturday 06 February and Sunday 07 February, morningand afternoon tea, lunch, conference satchel and Welcome Cocktails.Advanced Phlebology Course (Phlebology Part II)Entry to Basic or Advanced on Saturday 06 February and Sunday 07 February, morning andafternoon tea, lunch, conference satchel and Welcome Cocktails.ASM Registration: Mon 8 February - Wed 10 FebruaryEntry to all conference sessions, Welcome Cocktails, Conferring Ceremony and Gala Dinner,morning and afternoon teas, lunches, & conference satchel.Day registration:All conference sessions for one day, morning and afternoon tea, lunch, conference satchel and Welcome Cocktails if attendingSaturday 06 February.Spouses registration:All morning and afternoon teas, lunch and Welcome Cocktails. Non-medical spouses are welcome to attend the conferencesessions.REGISTRATION CONFIRMATIONAll delegates will receive written confi rmation of their conference registration once received and payment has been processed.Registration will not be processed unless accompanied by full payment.CANCELLATION POLICYCancellations can only be received in writing, and incur a loss of 50% of registration fees up until Friday 11 December 2009. Latercancellations forfeit registration fees paid. Any other refunds are at the discretion of the organisers. Substitutions can be made. Pleaseadvise substitutions in writing. Substitutions are only valid when confi rmed by Conference Matters.PRIVACYThe contact information supplied on the registration form will be distributed to the attending industry sponsors. Please advise inwriting if you do not wish to be included on this list.2206-11 February 2010 | The Langham Auckland | New Zealand
Australasian College of Phlebology 2010 | Annual Scientific Meeting & WorkshopsThe Langham Auckland | New Zealand | 06-11 February 2010PERSONAL DETAILSTitle: Miss / Mrs / Ms / Mr / Dr / Prof / Assoc ProfFirst Name: _________________________________Surname:___________________________________Company / Clinic Name: _________________________________________________________________Clinic location: __________________________________________________________________________City/TownPreferred Contact Address: ______________________________________________________________StreetPh: ____________________________Fax: ___________________________Mobile: _______________________Special requests: (ie dietary requests, disabilities, etc)________________________________________________________________________________________SuburbCountryVegetarian Vegan Kosher Halal Other________________________________________________________________________________________City/TownPost CodeEmail: ________________________________________________________________________________________________________________________________________________Additional Attendees: ___________________________________________________________________ Title, First Name, Last Name___________________________________CANCELLATION POLICY: Cancellations can only be received in writing, and incur a loss of 50% of registration fees within 21 days of the conference commencing.Later cancellations forfeit registration fees paid. Any other refunds are at the discretion of the organisers. PRIVACY: The contact information supplied onthe registration form will be distributed to the attending industry sponsors. Please tick this box if you do not wish to be included on this list.A. REGISTRATION FEES (GST Inclusive - NZD)BASIC & ADVANCED PHLEBOLOGY COURSE - 06-07 FEBBasic Phlebology 2 day course ........................... $ 990 $ _______Advanced Phlebology 2 day course .................. $ 990 $ _______ACP Basic & Advanced Trainees ......................... FREE $ _______University Students ............................................ FREE $ _______Less early bird discount if booked before 14 Dec 2009 Deduct $ 220.00Less discount if booked for main conference Deduct $ 110.00CONFERENCE MON 08 – WED 10 FEBACP Fellows & Medical Members ...................... $1,430 $ _______Non-members Medical ....................................... $1,540 $ _______ACP Basic & Advanced Trainees ......................... $ 990 $ _______ACP Affiliate Members (sonographers, nurses, scientists, students) $ 990 $ _______Non-member (sonographers, nurses, scientists, students) ................ $1,100 $ _______International & Keynote Speakers........ ............ FREE $ _______Exhibitors ............................................................ $ 440 $ _______Less early bird discount if booked before 14 Dec 2009 Deduct $ 220.00Or Daily RegistrationMonday Tuesday WednesdayACP Fellows & Medical Members - Days ____ @$ 550 $ _______Non MembersDays ____ @$ 660 $ _______ACP Affiliate Members/Trainees - Days ____ @$ 440 $ _______University Students ............................................ FREE $ _______Less early bird discount if booked before 14 Dec 2009 Deduct $ 110.00Thursday 11th September Diagnostic WorkshopsACP Fellows & Medical Members ...................... $ 770 $ _______Non-members Medical ....................................... $ 880 $ _______ACP Basic & Advanced Trainees ......................... FREE $ _______ACP Affiliate Members (sonographers, nurses, scientists, students) $ 440 $ _______Non-member (sonographers, nurses, scientists, students) ................ $ 770 $ _______University Student (ID required) ................................. FREE $ _______Less early bird discount if booked before 14 Dec 2009 Deduct $ 110.00Less discount if booked for main conference Deduct $ 110.00Breakfast SessionsBreakfast with the Stars (Mon 08 Feb) .................. $ 65 $ _______Medico Legal Breakfast (Wed 10 Feb) .................. $ 65 $ _______TOTAL REGISTRATION FEE (TOTAL A) $ _______B. SOCIAL & FUNCTION PROGRAMPartner registration (Non Medical) ................... $ 200 $ _______Conference Welcome Cocktails - Sat 6th Feb No. ____ $No ChargeScanmedics Conference Party - Sun 7th Feb .... $ 65 $ _______Graduation Ceremony Dinner - Mon 8th FebAttending Not AttendingExtra Tickets.......................................No._____ $ 275 $ _______TOTAL FUNCTION FEE (TOTAL B) $ _______C. ACCOMMODATION - The LanghamArrival Date _________ Feb Departure Date _________ FebKing Bed Two Twin Beds SmokingRoom Options:Classic Room (1-2 people) ______ nights @ $210 $ _______Executive Room (1-2 people) ______ nights @ $255 $ _______Club Room (1-2 people) ______ nights @ $335 $ _______Full Buffet Breakfast rate ______ nights @ $30pp $ _______TOTAL ACCOMMODATION FEE (TOTAL C) $ _______A+B+C = TOTAL ENCLOSED (NZD GST Inc) $PAYMENT DETAILS GST Tax Invoice Number 95-598-579I authorise Conference Matters to charge my Visa/Mastercard/AMEX/Dinersas detailed below, with the amount of $ _______________________________Card Number:Card expiry date ______ /______ Date______ /______ /_______Print Cardholder’s Name ______________________________________Cardholder’s Signature _______________________________________Cheque:$____________ (NZD) payable to: Conference Matters.Direct Credit 12-3099-0826112-000 Ref: Surname ACP2010Return this form to Conference Matters, Fax +64 (0)9 437 4089 or post to PO Box 1661, Whangarei, New ZealandAll Enquiries to Leon +64 (0)21 164 3815 or leon@conferencematters.co.nz
Page 1 and 2: The Australasian College of Phlebol
Page 3 and 4: INVITATION FROM THE COLLEGE PRESIDE
Page 5 and 6: Dr Nick MorrisonNick Morrison, MD,
Page 7 and 8: ORGANISING COMMITTEEProgram Chair:D
Page 9 and 10: PROGRAM AT A GLANCEThe academic pro
Page 11 and 12: Sunday 07 FebruaryBasic and Advance
Page 13 and 14: Monday 08 FebruaryScientific Progra
Page 15 and 16: Tuesday 09 FebruaryScientific Progr
Page 17 and 18: Wednesday 10 FebruaryScientific Pro
Page 19 and 20: Special Event:Breakfast with the St
Page 21: ACCOMMODATIONThe Langham Hotel | Au

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