Registration (June: Saturday 22/Sunday 23, 2024) - Agricultural Pathology and Biological Farming Service

First Name

Last Name

Phone/Mobile

Email

Business/Organisation

Address

City

State

Post Code

Attendees

Attendee 1 Details

First Name

Last Name

Attendee 1: Student

Student

Attendee 1: Session Selection

Attendee 1: Session Selection (Student)

Attendee 1: Cost

$

Attendee 2 Details

First Name

Last Name

Attendee 2: Student

Student

Attendee 2: Session Selection

Attendee 2: Session Selection (Student)

Attendee 2: Cost

$

Attendee 3 Details

First Name

Last Name

Attendee 3: Student

Student

Attendee 3: Session Selection

Attendee 3: Session Selection (Student)

Attendee 3: Cost

$

Attendee 4 Details

First Name

Last Name

Attendee 4: Student

Student

Attendee 4: Session Selection

Attendee 4: Session Selection (Student)

Attendee 4: Cost

$

Attendee 5 Details

First Name

Last Name

Attendee 5: Student

Student

Attendee 5: Session Selection

Attendee 5: Session Selection (Student)

Attendee 5: Cost

$

Summary and Payment

Thank you for supplying the required details for your registration. Please check the details displayed.

Cancellations: A $50 non-refundable booking fee applies to any cancelations of up to 7 days prior to commencement of the course, otherwise full fees apply.

Bill to:

Attendee 1:

Attendee 2:

Attendee 3:

Attendee 4:

Attendee 5:

No payment items has been selected yet

Payment Method

Credit Card

EFT (Direct Deposit)

Cheque

Credit Card

To pay by EFT (Direct Deposit) please use the following details:

Bank: Bendigo Bank Limited
BSB: 633-000
Account Number: 132 079 997

Payment Reference:

Amount:

(You will also receive a copy of these details via e-mail)

To pay by cheque please use the following details:

Make cheques payable to: Agpath Pty Ltd

Amount:

On the back of the cheque please write the reference:

(You will also receive a copy of these details via e-mail)