Expression of Interest

To receive more information as it becomes available and to express interest in attending the Beefsteak and Burgundy Club National Convention in 2009, please complete the Expression of Interest Form below. The form has a 'submit' link to send your information via email to the Conference Secretariat. Should you have difficulty for some technical reasons, kindly copy and paste the following information into your email and send to sally.brown@uq.net.au.

EXPRESSION OF INTEREST FORM

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Title:	[req]
First Name:	[req]
Surname:	[req]
BSB Club:	[req]
Address Line 1:	[req]
Address Line 2:
Address Line 3:
Suburb/Town:	[req]
State:	[req]
Country:
Postcode:	[req]
Telephone (work):	[req]
Facsimile:
Mobile:
Email:	[req]
Enter the code above:

This information is not being sent via a secure connection. If you are concerned about such details being sent electronically, please print out the page, fill in the details, and send by mail to: Sally Brown Conference Connections, PO Box 108, Kenmore QLD 4069 or fax to (07) 3201 2809.