APEC Online Form

PERSONAL INFORMATION (Full name required as per passport) * Required
*Title:	Mr Mrs Ms Miss Dr Prof Other (please specify)
*Family Name:
*Given Name/s:
*Nationality:
*Economy:
*Preferred Name On Name Badge
ACCOMPANING PARTNER DETAILS (Full name required as per passport)
Title:	Mr Mrs Ms Miss Dr Prof Other (please specify)
Family Name:
Given Name/s:
Nationality:
Preferred Name On Name Badge
CONTACT DETAILS
*Postal Address:
*Phone - Day:
Phone - Night:
Mobile:
Fax:
*Email:
SPECIAL REQUIREMENTS Please indicate as relevant
Mobility
Dietary
If YES please provide details:
ACCOMMODATION - INTERCONTINENTAL HOTEL WELLINGTON (website)
Classic Queen: $NZ299 Room only rate: Max two persons
Superior Queen: $NZ339 Room only rate: Max two persons
Priority Club Membership Number:
All prices are quoted in New Zealand Dollars and are inclusive of 15% GST. Rates may increase without notice due to imposition of government charges, taxes and levies. Rooms cancelled after 10 September 2012 will incur a cancellation fee. Intercontinental is a smoke free hotel.
PROFESSIONAL INFORMATION
*Please provide your professional information:
Architect:	Title: Practice:
Academic:	Title: Organisation:
Official:	Title: Organisation:
Other: (Please provide info)
*Would you attend an architectural tour of Wellington on the afternoon of 5 October?	Yes No
*Do you intend to spend time in New Zealand for recreational purposes prior to or after the Central Council Meeting?	Yes No (If Yes, please specify)
TRAVEL
The following is required for transfer arrangements in Wellington
*ARRIVAL - Date
ARRIVAL - Airline
ARRIVAL - Flight Number
*DEPARTURE - Date
DEPARTURE - Airline
DEPARTURE - Flight Number

The Conference Managers
New Zealand Conference Connexions Ltd
P O Box 22401
Khandallah
Wellington
NEW ZEALAND
Phone: 64 4 2378091 Fax: 64 4 2378062
jim@nzcc.net.nz