Registration Form 2016

Title

First Name (required)

Surname (required)

Position

Department (required)

Company (required)

Postal Address

Postal Address (continued)

City

State (required) -Please Select- Australian Capital Territory New South Wales Northern Territory Queensland South Australia Tasmania Victoria Western Australia Other

Country (required) -Please Select- Australia Afghanistan Aland Islands Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory British Virgin Islands Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Croatia Cuba Cyprus Czech Republic Democratic Republic of Congo Denmark Disputed Territory Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Federated States of Micronesia Fiji Finland France French Guyana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guinea-Bissau Guyana Haiti Heard Island and Mcdonald Islands Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Iraq-Saudi Arabia Neutral Zone Ireland Israel Italy Ivory Coast Jamaica Japan Jordan Kazakhstan Kenya Kiribati Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Moldova Monaco Mongolia Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Antilles Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island North Korea Northern Mariana Islands Norway Oman Pakistan Palau Palestinian Occupied Territories Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Islands Poland Portugal Puerto Rico Qatar Reunion Romania Russia Rwanda Saint Helena and Dependencies Saint Kitts and Nevis Saint Lucia Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia and Montenegro Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and South Sandwich Islands South Korea Spain Spratly Islands Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks And Caicos Islands Tuvalu US Virgin Islands Uganda Ukraine United Arab Emirates United Kingdom United Nations Neutral Zone United States Minor Outlying Islands United States Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe

Postcode

Business telephone (required)

Mobile number

Fax number

Email (required)

Accounts Department Email (to receive a copy of invoice)

Special needs (dietary, access, etc.)

Preferred title and full name on name badge (required)

My organisation is interested in sponsoring the conference (required)

• Yes
• No

May we include your name on the final delegate listing? (required)

• Yes
• No

Please select the day/s you want to attend:

Registration price $

Forums

If your registration includes "Day 3", please choose two forums:

Morning

• Ecotourism Planning and Development
• Ecotourism Quality and Standards
• Supporting Sustainable Tourism in Marine Reserves
• Ecotourism Futures: a national nature-based tourism strategy

Afternoon

• Innovative Approaches to Ecotourism Workshop
• Geotourism Forum
• Ecotourism in Protected Areas Workshop
• Creating Walking Destinations and EcoLodge Design

Discounts

Note: Only one discount can be claimed. Discounts do not apply to networking functions, entry fees, technical tours or transportation.

Please indicate whether you are:

Subtotal (Registration Fees) $

On Monday 21 November, there will be a special one-hour viewing of MONA Galleries exclusive for delegates – $20*

* Free to Tasmanian permanent residents. Only tick this box if you wish to attend the viewing and are not from Tasmania.

Note: For those who have selected for transport (see Step 6), a coach will depart MONA for the welcome cocktails at 5:30pm.

Subtotal (MONA Viewing) $

Please select the networking functions you would like to attend:

If requesting additional tickets, describe the person or persons they are for:

Name(s)

Special needs (dietary, access, etc.)

Subtotal (Networking Program) $

Pre-Conference Field Trip pricing and details will be released soon so keep your calendar free!

Please indicate if you are interested in participating in a field trip within the region:

• I am interested in participating in a field trip.
• I am not interested in participating in a field trip.

Global Eco is offering delegates ferry transfers to the conference at MONA and coach transfers to functions.

For more information, see the Delegate Transport page on this site.

Note: if you have any issues with mobility, please let us know in the comments box at the bottom of this form.

Subtotal (Transportation) $

I will be staying at:

To book your accommodation, please go to the accommodation page on this site. Further details and delegate rates available.

Registration $

MONA Viewing $

Networking $

Transportation $

Surcharge $

Total $

PAYMENT: All costs quoted are GST inclusive and a GST invoice will be forwarded with confirmation or registration and other fees paid.

PLEASE NOTE: All payments must be finalised before attending the conference.

Payment method (required) -Please Select- Government Invoice MasterCard Visa Amex

• Payment via Invoice is only available to Government agencies. Payments by Invoice incur an administration charge of 5%. Invoices must be paid within 14 days. Late payment incurs an interest charge of 1.5% per month.
• Selection of MasterCard, Visa or Amex will direct you to a secure payment gateway. Management Solutions (Qld) manages delegate registration and payments on behalf of Global Eco. Payments by credit card incur a surcharge of 3%.

All prices are in Australian Dollars and are inclusive of GST.

CANCELLATION POLICY:

• All cancellations must be made in writing to the Registration Officer.
• Cancellations made before 21 September 2016 incur a 25% penalty. There will be no refunds after this date.
• Substitute delegates are welcome, however the Registrations Officer must be advised in writing of any substitute delegates who will be attending.
• Sharing of registration with other parties is not permitted.

DISCLAIMER:

The program and nominated speakers are correct at the time of printing. Changes to the final program structure and nominated speakers may occur due to operation and administration issues or other factors outside the control of the conference organisers.

(required) Please select this box to indicate your acceptance of the payment surcharge fees and cancellation policy set out above.

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