School of Maths and Physics Workshop
8 - 11 July 2013
The Women’s College Accommodation Form

Please complete and return this form with payment to the address indicated below.

PERSONAL DETAILS

Surname 	First Name 		Title    		

Please circle:  Male / Female

Postal Address  

Telephone 	Fax 

Email   

Cancellation Details:

1.		A cancellation fee of $25 will be charged for any booking cancellation once    full payment has been received.

2.	A cancellation fee of first night’s accommodation will be charged should the booking be cancelled within seven days of the guest’s arrival date. 

3.	All cancellations must be received in writing.

SINGLE ROOM (shared ensuite facilities) – ensuite shared between two rooms
(Please note that numbers of these rooms are limited).

Arrival Date    					Departure Date  

Arrival Time  					Departure Time                  10 am

Total Number of Nights    a             @ AUS$84 per day, including breakfast =  

SINGLE ROOM (shared facilities)

Arrival Date    					Departure Date  

Arrival Time  					Departure Time                  10 am 

Total Number of Nights    a           at AU$74 per day, including breakfast =  

*    Please note that if your arrival is after 11.00 pm, you must contact the College office so  
     arrangements can be made.
*    Guests will be able to check in after 10am
	
Please indicate whether you have special dietary requirements, food allergies, other health concerns or any special needs you would like us to accommodate.

**	Booking fee: $20 fee per booking applies.
**	All rates quoted GST inclusive.

PAYMENT 

Payment can be made by bank cheque (drawn on an Australian Bank in Australian dollars only) payable to “The Women’s College”, or by MasterCard, Visa or Bankcard (American Express and Diners Card NOT accepted).

Total  Accommodation Payment – Including Booking Fee  (enter amount)

Cheque    	   Visa Card  	   	MasterCard  		

Name of Credit Card Holder

Credit Card Number							Expiry Date  

Signature							Date  

Please post (cheque), or email or fax (credit card payments) and Accommodation Booking Form with full payment before arrival date:

			Conference & Events Co-Ordinator
			The Women’s College
			College Road
			St Lucia   Qld   4067
			Australia

				Telephone 	61 7 3377 4500
					Fax  	61 7 3870 9511
					Email	conferences@womens.uq.edu.au