From: [required-email-address]
To: atkinson@cleo.murdoch.edu.au
Cc: [required-email-address]
Subject: REGISTRATION for EdTech '98

REMINDERS: Save this email as a text or word processor file, for your 
records. For credit card payments by fax or mail, or cheque payments, 
please undertake the further action detailed in either 1. or 2. below in 
order to complete your registration.

Title and name: [required-name]
Position: [position]
Department: [department]

Postal address:
[required-postal-address]

Email address is: [required-email-address]

Phone (work): [required-phone-work]
Phone (home): [phone-home] Fax: [fax]

Conference badge and organisation details:
Name (for badge): [required-badgename]
Organisation (for badge): [required-organisation]

Category of Registration (only one to be specified):
[regis-cat1][regis-cat2][regis-cat3][regis-cat4][regis-cat5][regis-cat6][association][regis-cat7][regis-cat8]

Please reserve places for me at:
Welcome Reception $15: [reception]
Conference Dinner $50: [dinner]

Please book accommodation for me at (only one to be specified):
[gc-single][gc-twin][gc-double][kpm-single[kpm-twin][kpm-double][csa-single][csa-double]
Check-in date: [checkin-date] Check-in time: [checkin-time]
Check-out date: [checkout-date]
I have made arrangements to share with: [share-with]
[share-sought]

Special requirements:
[special-reqs]

Method of payment (only one to be specified):
[pay-cat1][pay-cat2][pay-cat3]

Credit card details (if applicable). Complete all five items:
1. Type of card: [card-type]
2. Name of cardholder: [cardholder-name]
3. Card number: [cna]  [cnb]  [cnc]  [cnd]
4. Card expiry date: [card-expiry]
5. Amount to be debited (must correspond to the registration option plus
the appropriate additions for Welcome Reception, Conference Dinner
and first preference accommodation deposit if applicable): [amount]

REMINDERS: Save this email as a text or word processor file, for your 
records. For credit card payments by fax or mail, or cheque payments, 
please undertake the further action detailed in either 1. or 2. below in 
order to complete your registration.

1. Credit card via fax to Keynote Conferences.
Type your credit card details into the appropriate lines above, save again, 
and print your fully completed form. Please sign the printout here:

Your signature: _______________________________

Fax to Keynote Conferences (Aust) (08) 9380 4006 (Internat) +61 8 9380 4006

2. Cheque/Credit Card via postal service to Keynote Conferences.
In the case of payment by cheque, prepare a cheque payable to Ed Tech '98 
(cheques must be in Australian dollars). Print your fully completed form 
and with enclosed cheque post to Keynote Conferences. In the case of 
credit card via post, type your credit card details into the appropriate 
lines above, save again, and print your fully completed form. Please sign 
the printout here:

Your signature: _______________________________

Post to Keynote Conferences, PO Box 1126, West Leederville WA 6901 AUSTRALIA

Thank you for registering for Ed Tech '98!