The Australian Mars Exploration Conference

REGISTRATION FORM


Name ______________________ E-Mail Address_______________________


Postal Address __________________________________________________


City _____________________ State _________ Postcode______________


Phone (______) ___________________   [ ]Home  or  [ ]Work ? 

CONFERENCE REGISTRATIONfeetick one
Full$60[___]
Concession/Student$45[___]
Full Mars Society Member$45[___]
Concession Mars Society Member$30[___]

CONFERENCE BANQUET (optional)
7.30pm Saturday 12 May, venue to be announced.
Tick here [__] for vegetarian menu.

$60
optional
[___]

MARS SOCIETY MEMBERSHIP (optional)
If you are not already a member of the Mars Society
join now to qualify for the membership discount
by signing below:

I wish to become a member of the Mars Society Australia.

______________________________     _________
Signature                          Date
optional
Family$50[___]
Regular$40[___]
Student$25[___]

TOTAL

$_____

Pay by money order or cheque (make cheques to 'The Mars Society Australia').
Please print and fill out this form, then send it with payment enclosed to:

  AMEC Registrations
  PO Box 151
  CLIFTON HILL 3068