Fax form to Nic Geard (07) 3365 4999

Enrolment Form
UQ/SPSS Data Mining Workshop FEB 19-20, 2004

Please photocopy this form for multiple use. Complete the form in BLOCK letters.

Title: Mr / Ms / Mrs / Prof / Dr / other:                                                                           

Surname:                                                                                 First name:                      

Organisation:                                                                                                                 

Job title:                                                                                                                         

Business address:                                                                                                           

Telephone:                                                                               Fax:                                

Email:                                                                                                                            

For academics and full-time students only:

Researcher / Lecturer / Postgraduate / Undergrad:                                                     

University:                                                                                                                

Research centre, school or department                                                                       

 

Price of Workshops (GST inclusive)

	Industry	Academic & CSIRO	Student (full-time)
	$1,295	$495	$295
				Total:______

Payment method (please tick your payment method)

□    I have arranged an Interdepartmental Transfer (RIDS)

□    I have enclosed a cheque payable to the School of ITEE. Cheque number:                       

□    Please charge to my credit card the amount of $                           
Card type (please circle one):           Mastercard           Visa
Card Number                                              Expiry Date:                                                     
Name on Card                                                                                                                   
Signature of Cardholder                                                                                                      

Conditions of Enrolment: Should you need to cancel or transfer an enrolment, a full refund will be given if advised in writing at least 10 working days before the start of the program.  If you cancel after that date, the full value of the workshop will be charged.  The School of Information Technology and Electrical Engineering reserve the right to reschedule any workshop and to cancel a workshop if circumstances necessitate.  If a workshop is cancelled, The School of Information Technology and Electrical Engineering will make every effort to advise you and a full refund will be made.

Right of Refusal: The UQ/SPSS Data Mining Workshops are run by the School of Information Technology and Electrical Engineering, The University of Queensland, which reserves the right, in its sole discretion, to limit or deny access to the workshops to any entity or individual.  Receipt of an application and payment does not constitute acceptance until some form of acknowledgement or acceptance is sent; applications and payments that are not accepted will be returned within 30 days of receipt.