11th Australasian Piano Pedagogy Conference IncOpening doors: the complete musician in a digital age

2-6 July 2013, University of Southern Queensland, TOOWOOMBA QLD AUSTRALIAwww.appca.com.au

Major Sponsors of the 11th APPC Inc: Kawai Australia and the University of Southern Queensland

11th Australasian Piano Pedagogy Conference Inc Registration FormTitle: First Name: Surname:

Address:

Postcode:

Daytime Phone: ( ) Mobile:

Email:

Publicity Consent: I do / do not give my permission for any photos and/or video footage taken of me during theconference to be used for publicity purposes.

Dietary Requirements for Catering Purposes:

Regular (AUD$) Student (AUD$) Amount (AUD$)Entire Conference (includes lunch, morning and afternoon tea, all recitals and opening cocktail reception)Early Bird (by 03/05/2013) $435 $225 $Full Conference (by 07/06/2013) $495 $250 $Tuesday 1/2 Day (includes lunch and afternoon tea; does NOT include opening cocktail reception and opening recital)Tuesday 1/2 Day 02/07/2013 $60 $30 $Opening Cocktail Reception (6.00-7.15pm) & Recital (7.30pm)Opening Cocktail Reception & Recital Tuesday 02/07/2013 $60 $60 $Single Days (includes lunch, morning and afternoon tea and any recitals scheduled for the particular date)Wednesday 03/07/2013 $145 $75 $Thursday 04/07/2013 $145 $75 $Friday 05/07/2013 $145 $75 $Saturday 06/07/2013 $145 $75 $On-Site Accommodation (including breakfast & dinner) @$88 per nightMonday 01/07/2013 $88 $88 $Tuesday 02/07/2013 $88 $88 $Wednesday 03/07/2013 $88 $88 $Thursday 04/07/2013 $88 $88 $Friday 05/07/2013 $88 $88 $Saturday 06/07/2013 $88 $88 $TOTAL COSTS $

Additional recital tickets for guests MAY be available for purchase once registrations have closed

Payment: Payment must be made in Australian Dollars. The following payment methods are accepted:Cheques / Money Orders made payable to ‘11

thAPPC’ (Cheques must be drawn on an Australian Bank Account)

Credit Cards: Visa or Mastercard (Credit Card payments will appear as ‘Downs MicroSystems P/L Toowoomba’)

Bank Transfers for International Delegates: Bank Transfers for Delegates in Australia:Account Name: Australasian Piano Pedagogy Conference Inc Account Name: Australasian Piano Pedagogy Conference IncSWIFT Code: HBSLAU4T BSB: 638070BSB: 638070 Account Number: 12662097Account Number: 12662097Bank: Heritage Bank LimitedAddress: 400 Ruthven Street, TOOWOOMBA QLD 4350 AUSTRALIA

All Bank Transfer Transactions: Please provide full name as a reference

Payment is by: Cheque / Money Order___ Credit Card___ Bank Transfer___

Please charge my: Visa___ Mastercard___

Card Number: ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ Expiry Date____/____

Cardholder’s Name:

Cardholder’s Signature:

Please mail, fax, or email your booking to: 11th

APPC Inc (ABN 94 260 220 723)PO Box 292 DARLING HEIGHTS QLD 4350 AUSTRALIAF: +61 (0)7 4631 1133 E: appc@usq.edu.au