REGISTRATION BROCHURE.

Transcription

1 REGISTRATION BROCHURE

2 PLATINUM SPONSOR Satchels & Exhibition Passport GOLD SPONSORS Industry Symposium Lanyards & Handbook Juice Bar Industry Symposium ESPRESSO BAR SPONSOR PLENARY SESSION SPONSOR EXHIBITORS Agilent Technologies Australia AGRF Amicus Therapeutics Australian Genomics Health Alliance BGI BioMarin Pharmaceuticals Australia Elucigene Fulgent Diagnostics Genome.One HGSA Illumina Invitae Macrogen Oceania Perkin Elmer Prevention Genetics Roche Diagnostics Sanofi Genzyme Shire Sophia Genetics

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4 INVITATION On behalf of the Local Organising Committee we invite you to join us for the 41st Human Genetics Society of Australasia (HGSA) Annual Scientific Meeting to be held at the Brisbane Convention and Exhibition Centre, in Brisbane, Queensland, Australia on 5-8 August The theme for the conference is Next Generation: Coming of Age. We plan to explore the genetics of chronic and common diseases associated with ageing. The conference promises to be an exciting meeting with strong scientific content, covering various aspects of human genetics and genomics, including sessions around the following topics: The genetics of chronic and common diseases associated with ageing Cancer genetics Genetics for non-genetic health professionals Cognitive decline and dementia The Local Organising Committee and the Scientific Program Committee are assembling a cast of renowned scientists and clinicians from home and abroad to explore these themes from both an Australian and international perspective. In addition, there will be an education theme on the first day of the conference for GPs and non-genetic health professionals. We look forward to welcoming you to Brisbane, the sunny sophisticated capital city of Queensland and the gateway to the beautiful sunshine state and its many attractions. We look forward to seeing you in August! Ms Lemise Kassim Chair, Local Organising Committee LOCAL ORGANISING COMMITTEE Chair: Ms Lemise Kassim Sullivan Nicolaides Pathology Secretary: Dr Larisa Haupt - Institute of Health and Biomedical Innovation, QUT Treasurer: Dr David Fairbairn Pathology Queensland ASGC: Ms Melanie Boon - ASGC representative, Genetic Health Queensland ASGC: Ms Linda Wornham - Genetic Health Queensland AACG: Dr Michael Gabbett - AACG & EESIC Committee Representative, Genetic Health Queensland ASDG: Miss Charmaine Pollock - ASDG Representative, Sullivan Nicolaides Pathology CONFERENCE SECRETARIAT Event Manager Lisa King AACB Services Pty Ltd P: M: E: lisa@aacb.asn.au Registration, Accommodation & Abstracts Conference Logistics P: F: E: conference@conlog.com.au

5 INVITED SPEAKERS INTERNATIONAL SPEAKERS Prof Rossa WK Chiu, The Chinese University of Hong Kong, Hong Kong Prof David Glahn, Yale University School of Medicine, USA Prof Raoul Hennekam, University of Amsterdam, Netherlands Dr Jehannine Austin, University of British Columbia, Canada Dr Jan Hoeijmakers, Cancer Genomics Centre, Erasmus University, Netherlands NATIONAL SPEAKERS Dr William Brooks (Neuroscience Research Australia, NSW) Prof Matthew Brown (Institute of Health and Biomedical Innovation, Queensland University of Technology, QLD) Prof Jamie Craig (Department of Ophthalmology, Flinders Medical Centre, SA) Ms Kate Dunlop (Centre for Genetics Education, NSW Health, NSW) Prof Lyn Griffiths (Institute of Health and Biomedical Innovation, Queensland University of Technology, QLD) Dr Jürgen Götz (Clem Jones Centre for Ageing Dementia Research, Queensland Brain Institute, University of Queensland, QLD) Prof Sean Grimmond (Cancer Research & The Bertalli Chair in Cancer Medicine, University of Melbourne Centre for Cancer Research, VIC) Dr Steven Lane (Gordon and Jessie Gilmour Leukaemia Research Laboratory, QIMR Berghofer Medical Research Institute, QLD) Ms Nicole Martin (Virtus Diagnostics, Virtus Health, QLD) Dr Jim McGill (Department of Metabolic Medicine, Lady Cilento Children s Hospital, Brisbane, QLD) Dr Sylvia Metcalfe (Murdoch Childrens Research Institute, Genetics Education and Health Research, VIC) Prof Grant Montgomery (Institute for Molecular Bioscience, The University of Queensland, QLD) A/Prof Derek Richard (Cancer & Ageing Research Program, Queensland University of Technology, QLD) Dr Nic Waddell (Medical Genomics Group, QIMR Berghofer Medical Research Institute, QLD) Dr Margie Wright (Human Cognitive Ageing & Imaging Genomics, Queensland Brain Institute, The University of Queensland, QLD) PROGRAM SATURDAY 5 AUGUST REGISTRATION DESK OPEN From 0900 Australasian Society of Genetic Counsellors SIG Meeting Includes the ASGC AGM. Additional costs apply. Australasian Association of Clinical Geneticists SIG Meeting Includes the AACG AGM and HGSA Supervisors Workshop. Additional costs apply. Australasian Society of Diagnostic Genomics SIG Meeting Includes the ASDG AGM. Additional costs apply CONFERENCE OPENS - EXHIBITION & WELCOME RECEPTION 1930 AACG Dinner (additional costs apply)

6 PROGRAM SUNDAY 6 AUGUST REGISTRATION DESK OPEN MINDFULNESS MEDITATION SESSION WELCOME CONFERENCE OPENING BIOGEN PLENARY AND THEMED SESSION 1 - COGNITIVE DECLINE, ALZHEIMERS AND DEMENTIA Plenary 1: Dr David Glahn (USA) Plenary 2: Dr Williams Brooks Plenary 3: Prof Jürgen Götz GENETICS EDUCATION PLENARY SESSION Genetics Dr Di Milnes Genetic Counselling An Overview - Ms Melanie Boon Genetic Technologies - Dr Chirag Patel Resources for General Practice - Dr Sylvia Metcalfe MORNING TEA AND EXHIBITION PLENARY SESSION AND THEMED SESSION 2 GENETICS OF COMMON CHRONIC DISEASES Plenary 4: Dr Jehannine Austin (Canada) Plenary 5: Ms Kate Dunlop Plenary 6: Genetic risk prediction in common diseases - Prof Matthew Brown LUNCH, EXHIBITION & POSTER VIEWING CONCURRENT SESSIONS CONCURRENT SESSION 1: ASGC CONCURRENT SESSION 2: ASDG AFTERNOON TEA AND EXHIBITION PLENARY AND THEMED SESSION 3 - Q&A PANEL DISCUSSION Personal Genomics/direct to consumer Testing CONCURRENT INDUSTRY SESSIONS Agilent Technologies Industry Session Agilent Alissa Interpret a software platform for variant assessment support and reporting in clinical genetics and molecular pathology. CONCURRENT SESSION 3: AACG CONCURRENT SESSION 4: Genetics Education Choosing Wisely for Gene tests - Dr Michael Gattas Prenatal diagnostics - Dr Nicole Martin Cancer genetics - Dr Rachel Susman Sanofi Genzyme Industry Session The use of next generation sequencing as a diagnostic tool in the neurogenetic clinic lessons learnt over the last 4 years. Prof Phillipa Lamont (Head of Neurogenetic Unit, Royal Perth Hospital, Clinical Professor at the University of Western Australia) POSTER SESSION From 1930 Presidents Reception The Charming Squire Invite only event ASGC Mixer Venue TBA ASDG Mixer Venue TBA

7 PROGRAM MONDAY 7 AUGUST MINDFULNESS MEDITATION SESSION REGISTRATION DESK OPEN PLENARY SESSION AND THEME SESSION 4 DNA DAMAGE, AGEING & CANCER Plenary 7: Dr Jan HJ Hoeijmakers (Netherlands) Plenary 8: A/Prof Derek Richard Plenary 9: Dr Nic Waddell MORNING TEA AND EXHIBITION SUTHERLAND LECTURE Prof Lyn Griffiths LUNCH, EXHIBITION & POSTER VIEWING CONCURRENT SIG SESSIONS CONCURRENT SESSION 5: ASGC CONCURRENT SESSION 6: ASDG CONCURRENT SESSION 7: AACG AFTERNOON TEA AND EXHIBITION PLENARY AND THEMED SESSION 5 - DNA DAMAGE, AGEING & CANCER Plenary 10: Prof Rossa W.K. Chiu (Hong Kong) Plenary 11: Mutational mechanisms and oncogenic switches in solid tumours - Prof Sean Grimmond CONFERENCE DINNER CITY HALL TUESDAY 8 AUGUST MINDFULNESS MEDITATION SESSION REGISTRATION DESK OPENS PLENARY SESSION AND THEMED SESSION 6 GENETICS OF AGEING Plenary 12: Mendelian ageing - Prof Raoul Hennekam (Netherlands) Plenary 13: Dr Grant Montgomery Plenary 14: Dr Steven Lane MORNING TEA AND EXHIBITION HGSA ORATION Dr Jim McGill HGSA 2018 ASM PRESENTATION HGSA AGM and CERTIFICATE PRESENTATIONS LUNCH AND EXHIBITION SUBMITTED ORALS CONCURRENT SESSIONS AFTERNOON TEA PLENARY SESSION AND THEMED SESSION 7 GENETICS OF AGEING Plenary 15: Prof Jamie Craig Plenary 16: Dr Margie Wright CLOSING AND AWARD PRESENTATIONS

8 INDUSTRY EXHIBITION The Industry Exhibition will be open from 1700 Saturday 5 August to 1400 Tuesday 8 August in the Boulevard Auditorium Foyer, at the Brisbane Convention and Exhibition Centre (Grey Street). The Welcome Reception, morning and afternoon teas, and lunches will be held in the Exhibition area. ANNUAL GENERAL MEETING The HGSA AGM will be held on Tuesday 8 August 2017, at SOCIAL PROGRAM WELCOME RECEPTION SATURDAY 5 AUGUST 2017 Brisbane Convention & Exhibition Centre, Boulevard Auditorium Foyer, Join delegates and exhibitors for the first networking function of the meeting. This is the official opening of the Exhibition. The Welcome Reception is included with full registrations. Additional tickets are $70. CONFERENCE DINNER MONDAY 7 AUGUST 2017 City Hall, 64 Adelaide St, Brisbane City, The Conference Dinner will be held in Brisbane s iconic heritage-listed City Hall. Built in the 1920s and conveniently located next to King George Square, in the heart of Brisbane's Central Business District (CBD). With its sweeping marble staircases, vaulted ceilings, chandeliers and mosaic-tiled floor it promises to be an amazing venue for our gala dinner. Bus transfers will be provided. The Conference Dinner is included in full registration. Additional tickets are $150.

9 REGISTRATION FEES & ENTITLEMENTS All prices are quoted in Australian dollars and include GST. It is essential for all participants to complete a registration form and pay in full prior to the Conference. CONFERENCE FULL REGISTRATION Early Bird Fee - To 23 June 2017 Standard Fee - From 24 June 2017 HGSA Member - Full Registration $ $ Non Member - Full Registration $1, $1, Student Full^ $ $ Additional Exhibitor Registration* $ $ CONFERENCE DAY REGISTRATION Sunday Education Day $ $ Monday or Tuesday - HGSA Member $ $ Monday or Tuesday - Non Member $ $ Student - Day Registration^ $ $ CONFERENCE SOCIAL FUNCTIONS Day Registrations & Additional Tickets Welcome Reception (Saturday 5 August) $70.00 $70.00 Conference Dinner (Monday 7 August) $ $ SPECIAL INTEREST GROUP MEETINGS - Saturday 5 August Australasian Society of Genetic Counsellors SIG - Full Registration Australasian Society of Genetic Counsellors SIG - Student Registration Fee $ $ Australasian Association of Clinical Geneticists SIG - Full Registration $ Australasian Society of Diagnostic Genomics SIG - Full Registration $ (Early Bird to 23 June) $ (Standard from 24 June) CONFERENCE REGISTRATION ENTITLEMENTS All Conference Full Registrations will be entitled to: entry to all scientific sessions and the Exhibition morning and afternoon teas and lunches, from Sunday to Tuesday Conference satchel, name badge, handbook and meeting abstracts on Conference App. Welcome Reception (Saturday 5th August) Conference Dinner (Monday 7th August) Sunday Education Day Registrations will be entitled to: entry to all scientific sessions and the Exhibition on the Sunday morning and afternoon teas and lunches on the Sunday Posters Session on Sunday name badge, handbook and meeting abstracts on conference app. Monday & Tuesday Conference Day Registrations will be entitled to: entry to all scientific sessions and the Exhibition on the day/s registered only morning and afternoon teas and lunches on the day/s registered only conference satchel, name badge, programme handbook and meeting abstracts on conference app. Additional costs apply to Day Registration for social functions and guest tickets.

10 REGISTRATION FEES & ENTITLEMENTS CONT. *Additional Exhibitor Registration does not include the Conference Dinner or scientific sessions. ^Student Registration: is open to HGSA Student members and Non-Member students enrolled in an undergraduate degree, course or diploma and have a total taxable income of less than $35,000 per annum. Non Member students will need to supply a copy of their student ID and a letter confirming their enrolment. Please to lisa@aacb.asn.au. Shared Corporate registrations are available under the Non Member Full Registration Fee only. A maximum of three shared registrations per company apply (this can be shared by 3 people - 1 per day). The name badge will be under the organisations name. All SIG Registrations include: access to the SIG session, name badge, handbook, morning tea, lunch, afternoon tea and meeting abstracts on Conference App. (If you have also registered for the Conference, the conference satchel will be provided at the same time). REGISTRATION & PAYMENT Online registration is strongly encouraged. A hardcopy form is also available on the website. Registration Forms must be accompanied by payment of the registration fees and accommodation deposit. If you are registering online, a secure online form is available for credit card transactions. Credit cards accepted include Visa and MasterCard only. All amounts are in Australian dollars and include 10% GST. Overseas registrants should arrange payment by bank draft or money order payable in Australian dollars at an Australian bank. Delegates will receive a confirmation which includes the receipt and tax invoice. Cheques or bank drafts should be made payable to "Human Genetics Society of Australasia". All registrations will be acknowledged by . If you do not receive an confirmation upon the completion of your online registration, please contact the Meeting Secretariat to ensure that your details have been received. All registration and function payments must be received prior to the Annual Scientific Meeting. Onsite registration will be available and payment must be made at the time of registration. CANCELLATION POLICY Cancellations must be advised in writing to the Meeting Secretariat by 23 June A $130 cancellation fee applies to all cancellations. Refunds will only be issued in exceptional circumstances after this date, but substitute delegates are acceptable. REGISTRATION DESK All delegates must collect their registration packs from the Registration Desk to be able to access the Scientific Meeting. The Registration Desk will be located in the Boulevard Auditorium Foyer, on the Boulevard Level of the Brisbane Convention and Exhibition Centre (Grey St entrance) and open during the following hours: Saturday 5 August Sunday 6 August Monday 7 August Tuesday 8 August GOODS & SERVICES TAX A Tax Invoice will be issued with the receipt of registration. Unless otherwise requested in writing at the time of sending the registration enrolment form, the Tax Invoice will be in the name of the delegate. For international visitors, a tax refund may be sought at the airport for goods which are taken with them in their hand luggage when leaving the country. A tax refund is not available for goods or services consumed in Australia and therefore the GST component of conference registration fees, accommodation, tours, etc. are not claimable. DISCLAIMER The Conference Programme and registration information is correct at the time of printing. However, the organisers reserve the right to change the information where necessary without notice.

11 ACCOMMODATION Special room rates have been secured for delegates attending HGSA All accommodation rates quoted are in Australian dollars, inclusive of GST and are per room, per night (room only). All bookings are subject to availability. BOOK ACCOMMODATION ONLINE HOTELS Rydges South Bank 9 Glenelg St, South Brisbane Mantra South Bank 161 Glenelg St, South Brisbane Oaks Casino Towers 151 George St, Brisbane City Swiss-Belhotel Brisbane 218 Vulture St, South Brisbane Queen Room Superior Queen Room Studio Apartment One Bedroom Apartment Two Bedroom Apartment One Bedroom Apartment Two Bedroom Apartment Superior Room Deluxe Room $ $ $ $ $ $ $ $ $ For full details on the hotels, rooms and cancellation policies, please go to the Conference website at: DEPOSIT / PAYMENTS Full payment is required for all accommodation bookings. If booking online, you will have the option to pay your full payment by credit card, cheque or EFT. Payments will then be passed on to the hotels, and delegates are responsible for paying the full balance of their account and all incidentals on departure from the hotel. The hotel will be responsible for issuing tax invoices for accommodation payments upon check out. CLOSING DATE The closing date for bookings is 3 July Bookings made after 3 July 2017 will need to be made directly with the hotel. Bookings made direct with the hotel will be subject to availability and conference rates may not apply. CHANGE OF BOOKING & CANCELLATIONS Amendments and cancellations for accommodation bookings will only be accepted in writing to the Conference Secretariat by fax to or to conference@conlog.com.au. Cancellations received within 30 days of arrival may attract a penalty as indicated in the accommodation section. Please refer to each hotels cancellation policy on the website.

12 GENERAL INFORMATION BRISBANE, QUEENSLAND Brisbane is Australia s most exciting up-and-coming city. Constantly evolving with new offerings and experiences, the city has received glowing acclaim for its unique charms. We encourage you to arrive a little earlier or stay a little longer to discover what Brisbane and its spectacular surrounds offer you. Blessed with an enviable climate, Brisbane is renowned for its relaxed outdoor lifestyle, friendly locals and warm welcome. The city s burgeoning cultural and events scene has a reputation for blockbuster shows, international sporting matches, unique performances and exclusive exhibits. SOUTH BANK, BRISBANE The Brisbane Convention and Exhibition Centre is located in South Bank. South Bank is a unique riverside cultural, entertainment and dining precinct in the heart of the city of Brisbane. Set in lush subtropical riverfront parkland, it is a dynamic urban lifestyle and retail precinct that showcases Queensland's art and culture and is home to Brisbane's newest dining destination. Located on a one kilometre stretch of the Brisbane River, South Bank is home to the only sand and swimming beach in the heart of an Australian city. There is a diversity of attractions, with rainforest walks, more than 50 restaurants, cafes and bars, stylish shops, symphony orchestras, state opera companies, performing arts theatres and art culture including Australia's most celebrated Gallery of Modern Art. For more information on where to eat, drink, shop, play and stay in Brisbane, go to BRISBANE CONVENTION & EXHIBITION CENTRE Cnr Merivale and Glenelg Streets, South Bank, Brisbane QLD The Brisbane Convention & Exhibition Centre is a world-class purpose-built venue renowned for its operational and service excellence. The Centre is located in a unique urban cultural and entertainment precinct in the heart of Brisbane. CLIMATE Brisbane has a fabulous, truly comfortable sub-tropical climate ideal for outdoor enjoyment all-year round that averages 245 days of fine and sunny weather each year. August is the last month of winter in Brisbane. Days are fine and sunny with mild to warm temperatures averaging C. Nights are generally cool, and early morning temperatures can be crisp. TIME ZONE Brisbane is GMT hours. AIRPORT Brisbane International and Domestic Airport is located approximately 18kms from the venue and can be reached via Airtrain, taxi, bus or hire car.?costs Black & White Cabs - Phone: Yellow Cab - Phone: Airtrain - Catch the city s shuttle service Airtrain, which takes 22 minutes from Brisbane s international and domestic airports to South Brisbane station. The Convention Centre is then an 8 minute walk away. Airtrain operates seven days a week. Trains depart every 15 minutes in peak periods and depart every 30 minutes in non-peak, Monday to Friday. All services on Saturday & Sunday operate every 30 minutes. DRESS STANDARDS Smart Casual dress is the dress code for the meeting and functions.

13 GENERAL INFORMATION CONT. SPECIAL REQUIREMENTS (MEDICAL & DIETARY) Every effort will be made to ensure that people with special requirements are catered for. Should you require any specific assistance, please include a notation with your registration form to enable us to make your stay in Brisbane a pleasant and comfortable experience. VISAS Travellers to Australia need a valid passport or similar certificate of identification. All travellers to Australia, other than Australian and New Zealand citizens, are legally required to hold a valid visa to travel to Australia. Australia's Electronic Travel Authority (ETA) system is the world's most advanced and streamlined travel authorisation system. Delegates may apply for an ETA over the internet on Visit the Department of Immigration's website - for more information on ETAs, tourist visas, working holidays, business visits and students. It is recommended for International Delegates to commence application for their Visa into Australia at least three months prior to their intended arrival. DISCLAIMER The Human Genetics Society of Australasia (HGSA), the Conference Organisers and Secretariat will not accept liability for the damages of any nature sustained by participants or their accompanying persons or loss or damage to their personal property as a result of the HGSA Annual Scientific Meeting or related events. In the event of industrial disruption or other unforeseen circumstances, HGSA, the Conference Organisers and Secretariat accept no responsibility for loss of monies incurred by delay or cancellation. INSURANCE Registration fees do not include insurance of any kind. It is strongly recommended that all delegates obtain their own travel and medical insurance prior to coming to the Annual Scientific Meeting. The policy should include loss of fees/deposit through cancellation of your participation in the meeting, or through cancellation of the Annual Scientific Meeting itself, loss of airfares for any reason, medical expenses, loss or damage to personal property, additional expenses and repatriation should travel arrangements have to be altered. The Conference Organisers, HGSA, and the Secretariat will take no responsibility for any participant failing to insure. Please speak to your travel agent or airline in regard to this matter.

14 Registration Form Online registration is the preferred method of registration at For manual registrations, please use this form. Should you require the Tax Invoice to be sent to a different party, please provide the details at the time of submitting this registration form. Confirmation of your registration will be automatically ed to you. Your tax invoice will be ed to you separately. ABN: CONTACT DETAILS Title: Dr. Mr. Mrs. Ms. Miss. Other: Surname: Company: Position: Mailing Address First Name: City: State: Country: Postcode: Phone: Mobile: 2. PRIVACY POLICY please indicate Yes I agree to my name, organisation, state and country to be included on the delegate list on the Conference App, which will No be available to fellow delegates and sponsors, and made available to parties directly related to the event. 3. MEMBERSHP INFORMATION Non Member HGSA Member AACG Member ASGC Member ASDG Member ASIEM Member Yes, I am interested in joining HGSA - please send me membership details. 4. CONFERENCE REGISTRATION Full Registration Early Bird to 23 June 2017 Standard from 24 June 2017 Amount AUD$ HGSA Member $ $ Non Member ( tick if this is a shared corporate registration. See details on website) $ $ Student $ $ Additional Exhibitor $ $ Day Registration Sunday Education Day $ $ HGSA Member (Mon or Tues) $ $ Non Member (Mon or Tues) $ $ Student $ $ Day Registrations only: Please nominate day/s Sunday Monday Tuesday 5. SPECIAL INTEREST GROUP MEETINGS Saturday 8 August 2015 SIG Meetings Fee Amount AUD$ Australasian Society of Genetic Counsellors SIG - Full Registration $ Australasian Society of Genetic Counsellors SIG - Student Registration $ Australasian Association of Clinical Geneticists SIG - Full Registration $ Australasian Society of Diagnostic Genomics SIG - Full Registration (Early) $ (to 23 June 17) Australasian Society of Diagnostic Genomics SIG - Full Registration (Standard) $ (from 24 June 17) 6. SPECIAL INTEREST GROUP SOCIAL FUNCTIONS These are open to SIG Members only. Please indicate below if you are attending a SIG function. AACG Dinner (Saturday) open to AACG members ASGC Mixer (Sunday) open to ASGC members ASDG Mixer (Sunday) - open to ASDG members attending the SIG Meeting on Saturday 5 Aug. $30.00 ASDG Mixer (Sunday) - open to ASDG members ticket cost $30 (for non-delegates). 1

15 7. CONFERENCE SOCIAL PROGRAM Function Inclusive for Full Registration Member/Non Member/Student Additional Tickets Welcome Reception (Saturday) Tick if attending $70.00 Number of Additional Tickets Poster Session (Sunday) Tick if attending NA NA NA Conference Dinner (Monday) Tick if attending $ INDUSTRY SESSIONS Sunday 6 August, 5-6pm Please indicate below if you will be attending an Industry Session (these run concurrently on Sunday, from 5-6pm). Agilent Technologies Industry Session Sanofi Genzyme Industry Session 9. MINDFULNESS MEDITATION SESSIONS Please indicate below the Meditation Sessions you wish to attend. Limited numbers apply. Sunday Monday Tuesday Amount AUD$ 9. DIETARY / SPECIAL REQUIREMENTS If you have specific dietary requirements please indicate below (we will endeavor to cater to your needs but this may not be possible in all cases). If you have any other special requests (medical/mobility) please indicate below. 10. ACCOMMODATION HOTEL DATES: Check-in: Check-out: HOTEL ROOM TYPE $ per night room only Hotel Choice & Full Amount Rydges Southbank Queen Room $ Superior Queen Room $ Mantra Southbank Studio Apartment One Bedroom Apartment Two Bedroom Apartment $ $ $ Oaks Casino Towers One Bedroom Apartment $ Two Bedroom Apartment $ Swiss-Belhotel Brisbane Superior Room $ Deluxe Room $ I am twin sharing with: FULL AMOUNT: $ Full Accommodation Payment: Accommodation must be paid in full along with a credit card guarantee. The hotel will be responsible for issuing tax invoices for accommodation payments upon check out. Delegates are responsible for paying for all incidentals on departure from the hotel. Please refer to hotel cancellation policies available on the Conference website PAYMENT SUMMARY TOTAL AUD$ Option A Credit Card Payment: Option B Cheque or EFT: VISA MASTERCARD CHEQUE EFT Note: if accommodation was booked your credit card will also be passed on to the hotel to guarantee your booking. Full payment must also be made. Cardholder s Name: Card Number: CVV#: Amount $AUD: Cardholder s Signature: Expiry Date: Note: if accommodation was booked please supply credit card details which will be passed on to the hotel to guarantee your booking. Full payment must also be made. Please make cheques payable to: HGSA Overseas Delegates If paying by cheque please pay by Bank Draft in Australian Dollars FAX TO: (02) Mail to: HGSA 2017 ASM Secretariat Conference Logistics, PO Box 6150, Kingston ACT 2604 Ph: (02 ) E: conference@conlog.com.au 2