Fax form to Scott Bolland (07) 3365 4999

Matlab for cognitive modelling Workshop

Enrolment Form

July 1st, 2002

Please photocopy this form for multiple use. Complete the form in BLOCK letters.

Title: Mr / Ms / Mrs / Prof / Dr / other

Surname: First name:

Organisation:

Job title:

Business address:

Telephone: Fax:

Email:

For academics and full-time students only:

Researcher / Lecturer / Postgraduate / Undergrad:

University:

Research centre, school or department

Price of Workshop (GST inclusive)

Academics & CSIRO	$105
Students (full-time)	$55

Payment method (please tick your payment method)

q I have enclosed a cheque payable to the School of CSEE. Cheque number:

q Please charge to my credit card the amount of $
Card type (please circle one): Mastercard Visa
Card Number Expiry Date:
Name on Card
Signature of Cardholder

Conditions of Enrolment: Should you need to cancel or transfer an enrolment, a full refund will be given if advised in writing before noon, Friday the 29^th of June. If you cancel after that date, the full value of the workshop will be charged. The School of Computer Science and Electrical Engineering reserve the right to reschedule any workshop and to cancel a workshop if circumstances necessitate. If a workshop is cancelled, The School of Computer Science and Electrical Engineering will make every effort to advise you and a full refund will be made.