APIA Brisbane Dinner

Thursday, 19 February 2015

Brisbane Hilton
Guest Speaker:
Proudly Sponsored by:
Michael Roche
CEO of the Queensland Resources Council
“ Opportunities and Challenges in the
Resources Industry”
When 6:30pm Drinks for a 7pm Dinner
and
Where Brisbane Hilton
190 Elizabeth Street, Brisbane 4000

Price (incl GST) Members: $138 Non Members : $165

RSVP Payment must be received prior to the function unless approved by

APIA. To guarantee your booking please ensure you register prior
13 February 2015 to the date of RSVP. This RSVP date has been set by the venue and
we are unable to take bookings after this date.

Registration Details (Online Registration available at http://www.apia.net.au/event/brisbane-dinner-feb15/

Surname Nichols Name David
PLEASE ATTACH LIST IF INSUFFICIENT ROOM

Company iPipe Services Pty Ltd

Postal Address 2/112 Fison Avenue West
Suburb Eagle Farm Postcode 4009
Telephone 07 3252 4337 Fax
Email info@ipipe.com.au
Dietary Requirements
Payment Details
□ Electronic Funds Transfer
Bank: Westpac Branch: Manuka BSB: 032 729 Account Number: 162756 Swift Code: WPACAU2S
(Please advise PO number if required by your accounts department)
□ Enclosed is a cheque

□ Please debit my AMEX/Diners/Visa/Mastercard Amount

Card No Expiry

Cardholder Name Signature

Please return form to:

APIA ABN 29 098 754 324
PO Box 5416, Kingston ACT 2604 E: events@apia.asn.au
T: 02 6273 0577 F: 02 6273 0588
A tax invoice will be issued on receipt of booking form. Cancellations received prior to 13 February 2015 will be fully refunded.
Cancellations after this time will not be refundable, however, substitutions will be accepted.