Please complete the form, print and fax or scan/email to:
Fax: 07 3814 5771
Name & Date of Seminar:
Company Name:
Postal Address:
Suburb:
State:
Postcode:
Telephone:
Fax:
Approving Manager:
Position:
Email:
Attendee Details
1st Delegate Name:
2nd Delegate Name:
3rd Delegate Name:
4th Delegate Name:
Payment Details
Option 1 – Credit Card
Cardholders Name
Card Number
Expiry Date
Amount
Card Type
Cardholders Signature
Option 2 – Direct Deposit
Account Name: Project Procure Pty Ltd BSB: 014- 315 Account Number: 482671762
Please contact us on 07 3814 5771 for an invoice number.
Option 3 – Cheque
Please make cheques payable to Project Procure Pty Ltd
Mail with Registration form to: Project Procure Pty Ltd GPO Box 195 BRISBANE QLD 4001
Print Form