Reconciliation SA Reconciliation Week Breakfast - Registration Form

Reconciliation SA Reconciliation Week Breakfast - Registration form My Life in Song: Troy Cassar-Daley Walks the Talk to Recognition Friday 23rd May 2014, 7am to 9am Adelaide Convention Centre, North Terrace Get in early to secure your seat

Please complete and return this form to Reconciliation SA by Friday 16th May 2014, GPO Box 11023, Adelaide, 5001 or email to [email protected]. Enquiries to 0417 834 938.

Name: Telephone: Position: Organisation: Email: Mailing address: Postcode:

Registration details (Individual bookings are $60.50pp; tables of 10 are $605; Individual Friends $50; Corporate Friends are $500 a table. (all prices are GST inclusive)

If you are registering more than 10 people, please complete as many registration forms as necessary.

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Reconciliation SA cancellation policy:  Substitute participants may attend and any balance due will be paid.  Cancellations must be advised by email or on 0417 834 938 prior to Monday May 19th and will attract a $10 administration fee.  Cancellations received on or after May 19th will not be refunded.  Seats booked but left vacant will result in any outstanding fee being charged.

Reconciliation SA privacy policy: Reconciliation SA is committed to protecting the privacy of information collected for its internal use only about any persons or organisations. Personal information is not shared, sold, rented, traded or otherwise supplied to other third parties.  I have read, understood and agree to Reconciliation SA’s cancellation and privacy policies.