Conference Registration Form


Please fill out the Registration form below and press the send button. Alternatively, if you prefer, you can fax this form to us at fax number: +64 3 442 1617

EDS2010 Conference, Queenstown (15-17 March 2010)

Registration Type:


Your Details


Delegate:

Company Name:
Last Name:
First Name(s):

Gender:

Preferred Name:
Email:
Mobile:

Any Special Requirements:

Dietary:

Other:


Partner Details


Last Name:

First Name(s):

Gender:

Preferred Name:
Email:
Mobile:

Any Special Requirements:

Dietary:

Other:


Address Details

Phone:

Address:




City:


Hotel Accommodation Details


Arrival Date:	('DD/MM/YYYY')


Flight Number:
ETA:

Departure Date:	('DD/MM/YYYY')
Flight Number:

Do you require transport to or from the Airport?

	Yes

Type of Accommodation

Room/Bedding Configuration:



I will be sharing my accommodation with:



Smoking/Non-smoking?

Any Special Requirements?



Partner's Program


Will the delegate's partner be attending all of the Partner's Program activities?

	Yes

If no, please list options:



Social Program


Are you planning to attend all of the Conference Social Functions?

	Yes

If no, please list the functions that you are planning to attend:


Which activities would you like to participate in?

Golf	Tennis
Winery Tour	Fishing
Shotover Jet	Dart River Jet
Bungy Jumping	Walter Peak Sheep Station
Walks / Hikes	Spa Treatments
Sky Diving	4WD Trip

Please list requirements:



Payment Details


Cheque: Please make cheques payable to Queenstown Destination Management

Credit Card: Please indicate whether you would like to pay by Credit Card, and we will contact you for the details

I would like to pay by Credit Card, please contact me for details.


All registrations received will be acknowledged in writing within 7 days.

Note: If paying by cheque, we will contact you for your Credit Card details for the purposes of assisting with the hotel check-in process. No charges will be placed against your credit card.

© 2005 - 2008 Queenstown Destination Management - QDM - Conference, Incentive Management
PO Box 13, Queenstown, New Zealand - Phone: +64 3 4421628 - Fax: +64 3 4421617 - Email: -

Conference Registration Form

EDS2010 Conference, Queenstown (15-17 March 2010)