NZX Agribusiness Conference 2010 Registration Form

Please use either of the registration forms provided on this page to register for this years conference.

If you would like to pay by credit card (Visa or Mastercard) please complete the form below. Submitting this form will redirect you to a secure payments page.

If you would like to pay by cheque please download the printable registration form below, print it off and post it in with your cheque.

Credit Card Registration Form

(Fields marked with an * must be completed).

Contact Details:
First Name:*
Last Name:*
Name for Name tag:*
Occupation:
Address:
Region:*
Telephone:
Fax:
Email:*
	Male: Female:
Farm Type:
Sheep and Beef (Stock Units)
Dairying (No. of Cows)
Cropping (Hectares)
Other (list)
Ballance Agri-Business Golf Tournament
Please tick this box if you would like to take part in the Ballance Agri-nutrients sponsors golf tournament. Click here for more details
	Yes, I would like to play
Other:
For those delegates needing transport from Rotorua Airport to Taupo, there is a shuttle service available. Shuttle2U Ph: 07 376 7638 or Email: shuttle2u@xtra.co.nz. Please book independently.
Please list special needs:
Additional Names:

Payment Options: Please select the required number of registration options below.
Registration Option	# of Attendees
Full Conference Registration ($595 +GST):	0 1 2 3 4 5 6 7 8 9 10
Optional Thursday field trip($50 +GST):	0 1 2 3 4 5 6 7 8 9 10
Order Amount:	$0
The price is $595 + GST Day rate options : Tuesday $295 + GST Wednesday $295 + GST Dinner $110 + GST Registration is not secured until payment is received