Registration for the TSAA Awareness Week Conference 2010 BRISBANE
Your Name(s)
Your Address
Your Phone
Your Email
Venue
1 May B71 UQ Centre for Clinical Research Royal Brisbane & Women’s Hospital Herston Brisbane
Ticket Requirements:
Members $35.00
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Medical Professionals $55.00
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Non Members $40.00
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Educators $40.00
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Total Cost
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Payment Method
CHEQUE Payable to Tourette Syndrome Association of Australia Inc. Post to: P.O. Box 1173, Maroubra, NSW 2035
PAYPAL Pay via credit card online at www.tourette.org.au
DIRECT DEPOSIT St George Bank BSB 112879 Account: 033704995 Use your surname & initial as a reference & inform tourette@unwired.com.au of payment details.
SUBMIT
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