Federation Dinner Registration 2011

GUEST SPEAKERS:

"How Co-ops changed the lives of the Arctic People."
Mary Nirlungayuk, Corporate Secretary of Arctic Co-operatives Ltd.

"The past is always with us .... why co-op people should reflect on their history"
Ian MacPherson Emeritus Professor of History, University of Victoria

December 12, 2011
The Royal Exchange of Sydney, 1 Gresham Street, Sydney

Attendee Information

Name 1

Position 1

Name 2

Position 2

Name 3

Position 3

Organisation name

Address

Location

State

Postcode

Main Contact

Phone

Your Email
Please enter the email address of the person filling in this form

Special Dietary Needs

Co-operative Federation of NSW
207 Duns Creek Road, Duns Creek, NSW 2321
Phone: 02-4938 5308
Email: mail@coopsnsw.coop
Web: www.coopsnsw.coop

Registration fees: $99 per head (including GST)

Number of Attendees

Total Due

Payments must be received by November 30th

Payment

Cheque payable to Co-operative Federation of NSW

Transferred to:

Account name: Co-operative Federation of NSW Companion Credit Union
BSB: 805 022
Account number: 38609754

	To print a copy of this form for invoice purposes and/or to attach to a cheque for payment, in your browser, go to File/Print. All payments are required by 30th November.
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