WAIER Forum 2006: Registration Form

Western Australian Institute for Educational Research Inc.

21st Annual Research Forum
at Edith Cowan University, 2 Bradford Street, Mt Lawley
9.30 am - 4.30 pm, Saturday 5 August

Forum 2006 Registration

Please dump to printer, complete details and return with payment by 10 July to:
[Late registration may still be available after 10 July, please inquire - contact details below]

Dr Lina Pelliccione
Department of Education
Curtin University of Technology
GPO Box U1987, Perth WA 6845
L.Pelliccione@curtin.edu.au; Tel: 9266 2169

Name:  ________________________________________________ Title: ______

Institution: ________________________________________________________

Department: _________________________________________________________

Postal Address: _____________________________________________________

       ______________________________________________________________

Phone: _______________ (Wk) ______________ (Hm) _______________ (Fax)

Email: ______________________________________________________________

Membership and Registration Fee Full time employment: $120 Full time student: $75 Other categories: $75 Please make your cheques payable to "Western Australian Institute for Educational Research" or "WAIER" (Sorry, no EFTPOS or credit card facilities available)	*Fee includes:* Membership and Registration for the Forum IIER Journal subscription (2 issues per year) Research Seminars Forum Proceedings Morning tea and lunch Post-conference Happy Hour
Membership only (no Forum attendance): $60 Please see the Membership Only form for those who wish to join WAIER or remain a member (cost: $60) but who are unable to attend the 2006 Forum.	Membership and IIER Journal only
WAIER's ABN is 20 438 800 399
Inquiries: Dr Lina Pelliccione Email: L.Pelliccione@curtin.edu.au Tel: 9266 2169

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Last revised 18 May 2006. This URL: http://www.waier.org.au/forums/2006/regis-form.html
HTML: Roger Atkinson [rjatkinson@bigpond.com] and Clare McBeath [c.mcbeath@curtin.edu.au]