Control '96 Conference Registration

Please complete this form and fax it to (09) 473-9109 

Note: Control 96 will be of interest to a number of people in your
      company. Please copy this form for additional staff members.
      Every Conference Delegate must register prior to the Conference.


Registration Form   
Print Form to fill out

Name               ________________________

Position / Title   ________________________

Company            ________________________

Postal Address     ________________________

Phone              ________________________

Fax                ________________________

Conference Fee Non IMC(NZ) Members                  $ 70.00 (+GST)  ___________
Conference Fee IMC(NZ) Members                      $ 50.00 (+GST)  ___________
(Conference Fee Includes Registration, Copy of Proceedings, Morning and Afternoon teas)  
Cocktail Function                                   $ 30.00 (+GST)  ___________

Lunches                                             $ 12.00 (+GST)  ___________

Extra copy of Proceedings - Control 96              $ 20.00 (+GST)  ___________

                                                     TOTAL          ___________ 

                                My cheque / draft is enclosed for $ ___________ 

       Please make Payable to IMC(NZ) INC and send to:

             CONTROL '96
             National Secretary IMC(NZ) INC 
             PO Box 26-314 
             AUCKLAND 3 

       I would also like information about: (please tick) 

             __ Accommodation 

             __ Air New Zealand discount 

GST Registration No: 45-372-944 
Tax Invoice issued on payment. 
Please copy this registration form for your records 

The above information will be provided to Control '96 Exhibitors. 
If you do not wish to be included on the mailing lists please write to the IMC Secretary: Cedric Randerson P.O. Box 26-314, Auckland 3 Phone: 09-523 1310, Fax: 09-522 1833