Australian
Hand Therapy Association Inc.
ABN 72 874 453 636
PO Box 182 MUNDARING WA 6073 Ph:
08 9578 3348 Fax: 08 9574 6078 Email info@ahta.com.au
CERTIFICATE
COURSE IN HAND SPLINTING
(LEVEL 1) 2008
PERTH 21-22 JUNE 2008
Occupational Therapy Dept,
G Block, Sir Charles Gairdner Hospital, Hospital Avenue, Nedlands
REGISTRATION
FORM &
TAX
INVOICE
REGISTRATION(Please
complete form on-screen and print - retain a copy for your records)
Date of
Invoice
Name
PT OT
Organisation
Postal Address
Suburb
State
P/C
Phone
Fax
Email
COST
(includes all notes, text, materials, am/pm teas and lunch)
If
using credit card, please select $15.00 surcharge Inc GST
SELECT
TOTAL PAYABLE Inc GST
Select
method of payment
Select card type
MasterCard
Visa
Card Nș
Expires:
Name on Card
Signature:
_______________________________________
For credit card or
direct deposit payments, please fax completed form to 08 9574 6078
If paying by direct
deposit, please quote your surname to identify your online payment.
Bank: Bank of
Queensland
BSB: 124-001
A/c Nș: 11
244637
A/c Title:
Australian Hand Therapy Association Inc.
If paying by cheque,
please mail to: AHTA Inc. PO Box 182 MUNDARING WA 6073
AHTA Policy on
Cancellation / Refunds of Workshop fees
AHTA reserves the right to cancel or postpone any event. If this
occurs all monies will be refunded to the registrant. Should you
be unable to attend, a substitute delegate is always welcome and should
contact the AHTA Secretariat. If the substitute is not an AHTA
member, the non-member fee will apply and extra payment will be due.
A refund (less 30% to cover the administration costs, and less the cost
of any supplied texts) will be given for a written cancellation received
10 working days prior to the event. Cancellation after this will
be ineligible for a refund. All registrants will be notified in writing
or by phone / e-mail to confirm a place or to advise if their name has
been placed on a waiting list for each seminar/workshop. If you
have not received this confirmation 7 days prior to the seminar please
contact the secretariat (info@ahta.com.au).
If an event is cancelled, all registrants will be notified either by
mail, phone or e-mail.
Australian Hand
Therapy Association Inc.