CONFERENCE 2014 - AMMA

REGISTRATION AND CALL FOR PAPERS

IN C.

M ED ICIN E ASSOCIATION AU

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ThE hILTON, SyDNEy, 17-19 OCTObER

ThANk yOu TO OuR mAjOR SPONSOR

AUSTRALASIAN MILITARYMEDICINE ASSOCIATIONCONFERENCE 2014

THE HILTON, SYDNEY. 17-19 OCTOBER







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wELCOmEOn behalf of the Organising Committee of the 2014 Australasian Military Medicine Association Conference we invite you to attend the 23rd Annual AMMA Conference. Last year our conference was held in Adelaide and we had over 400 delegates attend. This year the conference will be held in Sydney at the Hilton and it is expected that between 400-500 delegates will attend, together with over 35 exhibitors.

This year we recognise 100 years of World War I and the sacrifices our serving men, women and their families made. This was the “war to end all wars”, the Great War but a war that introduced horrific injuries from chemical warfare and other battlefield injuries, including what we now know today as PTSD, shell shock.. Back then men who enlisted or volunteered in the Corps could be transferred to the Field Ambulance even though they had no training or medical background, unlike the medics we have today who are highly trained health professionals.

This conference will reflect on how they achieved what they did with so little, what it has enabled us to achieve today, and what prospects we have for the future.

With this in mind, we recognise that many in the health community could make a useful contribution to the success of the Conference and we call for those people to submit papers which may include veterans’ health, rehabilitation, trauma surgery, mental health, health surveillance, operational health, ethics and many other streams.

Our annual award for the best presentation at the conference, The Weary Dunlop Award will be presented on the last day of the conference together with the best conference poster and an award that was initiated last year, the Photo Gallery Award so we encourage you all to submit your abstracts, posters and photos for consideration.

We do hope that you will be able to join us for an excellent and challenging event and to meet new and old colleagues to network and exchange ideas.

We look forward to seeing you in Sydney in October.

Dr Greg Mahoney President, AMMA

whO ShOuLD ATTENDMilitary Health personnel

Health professionals with an interest in Defence

Reservists

Members of the emergency health profession

Human Factors Specialists

Defence Health Scientists

Trauma Specialists

Emergency Service personnel

Royal Flying Doctors Service personnel

Care Flight

Veterans Affairs personnel

Government Health employees

University Medical and Health Units

Veterans and retired veterans

ImPORTANT DATESCall for Abstracts Opens Monday 24 March

Call for Abstracts Close Friday 6 June

Notification to Authors Monday 7 July

Registration Opens Monday 24 March

Early Bird Registration Close Friday 1 August

Registrations Close Friday 17 October

Conference Dates Friday 17 October – Sunday 19 October

Conference Dinner Saturday 18 October

Trade Exhibition Friday 17 October – Saturday 18 October

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CONFERENCE LOCATIONLOCATION – SyDNEy

Sydney is Australia’s largest city, with a population of approximately 4.6 million. It is renowned for its stunning harbour and unique combination of cosmopolitan culture and natural amenity. Many of the city’s beaches, bays and parks are located close to the city centre. Referred to in planning documents as a “city of cities”, metropolitan Sydney’s eclectic array of suburbs, neighbourhoods and centres are known for their diverse characteristics. Relaxed beach communities sit juxtaposed to vibrant, innercity urban villages, while more traditional outer-ring suburbs contrast with inner-urban regeneration areas.

As Australia’s oldest city, Sydney has a rich cultural and architectural heritage. The area’s Aboriginal heritage, which dates back 50,000 years, is reflected in the names of many streets and suburbs and is celebrated in galleries, museums and parks throughout the city. It is believed that some of Sydney’s arterial roads were even constructed on Aboriginal walking tracks. European settlement in Australia began over 200 years ago at ‘the Rocks’ in Sydney’s inner harbour. The historic and vibrant ‘Rocks’ quarter, and nearby iconic landmarks such as the harbour bridge and the Sydney Opera House, reflect unique eras in the city’s development. Throughout its history, Sydney has attracted large numbers of overseas migrants. The city’s contemporary cultural diversity is reflected in its many restaurants, markets and entertainment venues.

VENuE – hILTON SyDNEy

With exceptional facilities for business or leisure, Hilton Sydney is superbly located right in the heart of the city, with magnificent views and convenient access to Sydney's favourite attractions , including Darling Harbour, Sydney Harbour Bridge and Bondi Beach.

Boasting expansive and stylish conference space for up to 3,000 attendees, Hilton Sydney is the premier location for conventions in the city. With 579 beautifully-appointed guest rooms, 23 meeting rooms and four floors of dedicated meetings and exhibition space, Hilton Sydney provides business people with superb facilities for all types of events.

The Hilton Sydney hotel also boasts stylish bars, with dining by celebrity Chef / Restaurateur Luke Mangan at the famous glass brasserie. Or relax with a cocktail on the rooftop terrace at Zeta Bar and enjoy live music at the iconic Marble Bar.



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CALL FOR AbSTRACTSINVITATION TO SubmIT AbSTRACT

The last two decades have seen almost continuous activity in both active military and humanitarian activities around the world. Issues arising have resulted in a greater awareness of military medicine and veterans’ health in both military and civilian communities and have caused us to review our responses, actions and attitudes in all fields of military medicine and veterans’ health. The AMMA Conference provides a forum that allows us to discuss our experiences, and review our concepts and ideas.

The Scientific Committee will be seeking to create a program that addresses a spread of issues and professional experiences that attract a broad discipline of delegates. The Scientific Committee would therefore like to take this opportunity to invite you to submit an abstract.

Topics can include, but not be restricted to:

• Aero medical Evacuation

• Psychological Health

• Aviation Medicine

• Ethics

• Tropical Medicine

• Bioterrorism

• Military Medical History

• Military Nursing

• Operational Health Support

• Medical Logistics

• Medico-Legal aspects

• Medical Fitness

• Battlefield Surgery

• Underwater Medicine

• Clinical Practice

• Operational Health & Safety

• Human Factors

• Disaster Health

• Military Dentistry

• Field Hygiene

• Medical Equipment

• Veterans’ Health (including PTSD and Rehabilitation)

• Nutrition

• Trauma

ORAL PRESENTATIONS

Selected authors will be invited to present their papers in an appropriate session. Presenters will be invited to participate in a question and answer period at the conclusion of each session.

POSTER PRESENTATIONS

Submissions should relate to the themes and authors should nominate poster when submitting their abstract. Abstracts submitted for oral presentations that have not been accepted may be invited to provide a poster presentation.

AbSTRACT SubmISSION INSTRuCTIONS

Abstracts MUST be submitted by following the links from www.amma.asn.au/amma2014 to the Conference website and clicking on the Call for Papers tab. Authors MUST submit a separate abstract for each presentation put forward for consideration.

Abstracts must be received no later than Friday 6 June 2014

• All abstracts must be submitted electronically using the AMMA abstract template and must be submitted online at www.amma.asn.au

• Faxed abstracts will not be accepted.

• Abstracts should be no longer than 500 words.

• Notification of Acceptance will be provided by Friday 4 July

Abstracts will be reproduced in the conference proceedings and the Journal of Military and Veterans’ Health. We also request permission to reproduce your presentation on the Conference website.

It is hoped that authors will also submit full papers for publication in the Journal of Military and Veterans’ Health.



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CALL FOR AbSTRACTSbATTLEFIELD PhOTO GALLERy

The Battlefield Photo Gallery is again open for award this year. Photos will be displayed at the entrance to the Exhibition Area. Delegates at the conference will vote for the best picture and a prize will be given to the most engaging photo. Submissions should be on A4 photographic material to the AMMA Secretariat, 113 Harrington Street, Hobart. Please note as with abstract submissions it is up to the photographer to ensure that personal clearance and authorisation has been given by the respective individual(s) and authorities.

INFORmATION ON ACCRm AND RACGP AND POINTS

The ACCRM CPD and RACGP QA & CPD programs aim to assist Australian General Practitioners and Health Professionals maintain and improve the quality of care they give to patients and promote the highest possible standards of care to the community.

The Australasian Military Medicine Association is proud to have been associated with these programs in the past, and pending approval by the ACCRM and RACGP will again be participating in these initiatives to enable GP’s and Nurses another opportunity to earn further points.

AmmA AwARDS

Weary Dunlop aWarD - $750

The Australian Military Medicine Association is committed to supporting military medicine, and as a result, present the Weary Dunlop Award for the best original presentation given at the annual Conference. The award is open to all presenters at the Conference and is named in honour of Sir Edward “Weary” Dunlop, who passed away in 1993.

The award prize is $750 and publication of the paper in the association’s journal Journal of Military and Veterans’ Health. It is open to all presenters, whether or not they are members of AMMA and must be an original presentation to which they have intellectual property rights.

ConferenCe poster aWarD - $250 – sponsoreD by InternatIonal sos

The Conference Poster award is open to those whose abstracts have been accepted as a Poster submission. It is awarded It is open to all presenters, whether or not they are members of AMMA and must ben an original presentation to which they have intellectual property rights.

patron’s prIze - $250

The Patron’s Prize will be awarded to the AMMA Member with the best article published in a peer reviewed journal. It must be a health related article and published within the past financial year (1 July 2013 – 30 June 2014). Members must submit their article for consideration to the AMMA Secretariat [email protected] by 31 July 2014.

Journal eDItor’s prIze - $750

The award for the best paper published in the Journal of Military and Veterans’ Health within a 12 month period will be judged and presented by the Chief Editor.

JMVH neW autHor prIze - $500

The award for the best paper published within a 12 month period by an author who has not previously published in the Journal of Military and Veterans’ Health will be judged and presented by the Chief Editor.

best Veteran paper - $1500 sponsoreD by repatrIatIon founDatIon InC.

The Veterans Paper Prize is awarded by the Editorial Board of The Journal of Military and Veterans’ Health for the best original paper on veterans' health published in each volume of the Journal (constituting the issues published in each financial year). The Editorial Board will determine the criteria and method for determining the award of the Prize.

An original paper is one that is published in any of the following Sections of JMVH:

Original Papers; Short Communications; Case Studies; Review Articles; History.

Membership of the Association is not a requirement for the granting of the Award.

pHoto Gallery - best pHoto aWarD

Entrants to the photo competition will be judged by conference delegates and the president of AMMA. The winning entrant will receive a $150 cash prize.



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REGISTRATIONAll who wish to attend the 2014 AMMA Annual Conference, including invited speakers and exhibitors, should complete a registration form and return it to the Conference Manager. Registration forms should be completed on-line or by hard copy in this document.

REGISTRATION FEES AND ENTITLEmENTS Full Registration for members, non-members and students* includes attendance at all sessions during days of Friday 17-19 October 2014. Full registration also includes; one set of Conference proceedings, satchel, name badge, lunch, morning and afternoon refreshments and entry to the Conference Welcome Reception & Conference Dinner. You will have an opportunity later in the form to purchase additional tickets to the social functions.

Day Registration includes attendance at sessions on the nominated day of attendance, one set of Conference proceedings, satchel, name badge, lunch, morning and afternoon refreshments on the day of attendance. Day registration does not include any of the social program functions. Tickets to attend any of the social functions need to be purchased separately.

*STUDENT REGISTRATION is open to those who are undertaking a primary health care degree. Your student no and name of university must be submitted for verification when registering.

Payment of fees must accompany all registrations and may be made by personal or company cheque or credit card. We accept Visa, MasterCard. Cheques should be made payable to Australian Military Medicine Association. A Tax Invoice and confirmation letter will be issued when payment is made. You may also book accommodation and social events on line when you register.

PLEASE NOTE: Early bird registrations must be paid in full by 1 August 2014. If payment is not received registration fee will be charged at the standard rate.

full registrationsearly birdbefore 1 august

standardafter 1 august

Member $850 $950

Non Member $970 $1095

Student Member $695 $775

Student Non Member $775 $855

Day registrations

Member Day $375 $425

Non Member Day $425 $475



additional tickets

Conference Welcome Reception $80

Conference Dinner $190

PROVISIONAL PROGRAmUpdates will appear on the Conference website and a confirmed program will be released shortly after the closing date for abstracts.

tHursDay 16 oCtoberAMMA Workshop - Essential Military Sports and Musculoskeletal Medicine 2014

frIDay 17 oCtober Welcome and Conference Opening

Keynote Presentation

Concurrent Sessions (4 Streams)

Conference Welcome Reception

Trade Exhibition

saturDay 18 oCtoberPlenary Presentations

Concurrent Sessions (5 Streams)

AMMA Annual General Meeting

Conference Dinner

Trade Exhibition

sunDay 19 oCtoberPlenary Presentations

Close and AMMA Awards



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SOCIAL PROGRAm

CONFERENCE wELCOmE RECEPTIONExhibition Area, Hilton Sydney, Sydney

Friday 17 October

1730 - 1930

Dress - Neat casual

Additional tickets - $80

A Welcome Reception will be held in the Trade Exhibition area at the Hilton Sydney on Friday 17 October commencing at 1730. This will be a chance to catch up with colleagues after the first day and explore the trade exhibition stands further.

CONFERENCE DINNERSydney Town Hall

Theme - Fields of France

Saturday 18 October

1900 - 2330

Dress - Dinner/Lounge suit, after-five wear

Additional tickets - $190

The Conference Dinner will be held on Saturday 18 October commencing at 1900. Dress in red and dance the night away to something special. The Conference dinner is the social highlight of the program and should not be missed.



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ACCOmmODATION

HIlton syDney - ConferenCe Venue 5 Star, 488 George St

With exceptional facilities for business or leisure, Hilton Sydney is superbly located right in the heart of the city, with magnificent views and convenient access to Sydney's favourite attractions , including Darling Harbour, Sydney Harbour Bridge and Bondi Beach. Hilton Sydney provides five star services to ensure all our guests have a memorable, personalised experience.

Hilton King Guest Room $349.00 per night

Mantra on Kent 400 metre walk from the Conference Venue 4 Star, 433 Kent St

Newly refurbished apartments conveniently located between Darling Harbour and the Sydney CBD, perfect for business and leisure travellers alike.

Mantra on Kent offers contemporary, stylish Sydney accommodation in the heart of the CBD. Enjoy all modern accommodation conveniences, including 24-hour reception and access to internet in your room and the lobby lounge. Distance to Darling Harbour 100m, Pitt St Mall & Westfield Shopping Centre 300m, Circular Quay 1.2km.

One Bedroom Apartment $305.00 per night

parK royal DarlInG Harbour 650 metre walk from the Conference Venue 4.5 Star, 150 Day St

With Darling Harbour and the Sydney CBD just minutes away, our hotel is conveniently located near exciting entertainment districts, restaurants, cafes and the most popular attractions in Sydney. You can also enjoy gym access, or relax in the PARKROYAL Club Lounge while taking in sweeping views of picturesque Darling Harbour.

Superior Room $264.50 per night

Superior Room including Breakfast $293.25 per night

aDIna apartMent Hotel syDney 450 metre walk from the Conference Venue 4.5 Star, 511 Kent St

All accommodation options at the Adina Apartment Hotel Sydney have been designed to create an atmosphere of elegance whilst combining all the comforts of home.

One Bedroom Apartment $240.00 per night

Premier One Bedroom Apartment $260.00 per night



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ACCOmmODATION

IbIs syDney DarlInG Harbour 1km from the Conference Venue 3.5 Star, 70 Murray Street, Darling Harbour

Centrally located in the heart of Darling Harbour, ibis Sydney Darling Harbour is one of Sydney's most popular 3.5 star hotels. Surrounded by an array of tourist attractions, restaurants and bars, ibis is renowned for its quality, simplicity and value for money with many rooms boasting spectacular views of Darling Harbour. With a popular bar, restaurant and 24 hour reception, ibis has affordable rates and friendly service and is perfect for business or leisure travel during a Sydney visit.

Pyrmont View Queen Room $219.00 per night

parK reGIs CIty Centre syDney 300 metre walk from the Conference Venue 3.5 Star, 27 Park St

Park Regis City Centre, surrounded by Sydney's best shopping, restaurants, sightseeing and entertainment, cannot be beaten for location, service and value for money.

In your modern hotel room incorporating contemporary decor, air-conditioning, ensuite bathroom with hairdryer, opening windows, tea and coffee making facilities, refrigerator, work desk, WIFI /high speed internet connection, direct dial telephone and 32" HD TV.

Our guests are invited to experience our rooftop outdoor pool and sundeck that affords magnificent 360 degree views over Sydney Harbour, Darling Harbour and the city.

Premier Hotel Room $225.00 per night

Metro Hotel on pItt 450 metre walk from the Conference Venue 3.5 Star, 300 Pitt St

Superbly located, Metro hotel on Pitt is the perfect option for both the leisure and corporate travellers seeking affordability and convenience in Sydney’s CBD. Offering 115 well-appointed rooms, each with a spacious bathroom with roomy walk-in showers, Metro Hotel on Pitt has the perfect room for every occasion. All rooms have high speed Internet connection and for guests travelling without a laptop we also have an Internet Kiosk located in the lobby area (charges apply).

Standard Room $189.00 per night

ACCOmmODATION CANCELLATION POLICy

To confirm your booking, your supplied Credit Card will be transferred to the hotel you have selected. The hotel may

choose to charge your card with a deposit prior to your arrival to secure your booking. If you arrive 24 hours later than your

indicated arrival day you may find that you have forfeited one night’s accommodation as a cancellation fee. Please note that some hotel cancellation policies may require 100% of the total

booking amount to be paid for any cancelled rooms.

If you need to cancel your accommodation booking within 45 days of your arrival date, any refund whether cash or credit card,

will be subject to the hotel cancellation policy. Therefore no accommodation refund can be guaranteed within 45 business

days of the conference. Please note that most hotels have surcharges on credit card transactions; please contact your

hotel directly if you wish know their individual rates.



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GENERAL INFORmATION

REGISTRATION DESkThe Registration Desk will be located on Level 3 of the Hilton Sydney, near the Grand Ballroom

Thursday 16 October 0700 - 1800Friday 17 October 0700 - 1800Saturday 18 October 0730 - 1700Sunday 19 October 0830 - 1300

ACkNOwLEDGmENT OF REGISTRATIONYour registration will be acknowledged on submission with confirmation of your requirements, upon receipt of your completed registration form. PLEASE NOTE If you submit your application online, you will automatically be provided with an id so that you can update and change your personal details up to two week prior to the event.

All updates regarding the Conference will be posted to the Conference website http://www.amma.asn.au/amma2014/

Your hotel booking will be confirmed only on receipt of your credit card details.

At the Conference you will receive the Conference and name badge upon arrival. The name badge will be your official pass and must be worn to obtain entry to all sessions and to social functions. Additional tickets will be issued for partners who are attending social functions.

CANCELLATION AND REFuND POLICyAll cancellations must be in writing. Cancellations postmarked on or before Friday 12 September 2014 will incur a fee of 50% of the registration amount. No refunds will be given for cancellations postmarked on or after this date.

The Conference Organisers reserve the right to change dates, program and speakers without notice, as a result of circumstances beyond their control.

GETTING TO ThE CONFERENCE

aIr

All airlines fly daily to Sydney, with regular connections. No official carrier has been nominated for the conference due to competitive airfares available via the internet.

If you are travelling to Australia, and transferring to either Virgin, Jetstar or Tiger, please note, domestically these airlines have specific luggage allowances, and it is recommended that you check these with your travel agent when you book your flight as excess luggage charges can be high.

aIrport transfers

Taxis and the Airport Link offer the most convenient transfers between the airport and Sydney. The cost of the Airport Link to Town Hall Station is $16.40 one way or $32.80 return.

aIrport taxI serVICes

Taxis are available at all times of the day from the front of the terminal. An average fare to the city is $35-45.

wEb PAGESponsored By

Up to date Conference information is available from the Conference web site located at: www.amma.asn.au/amma2014. Please check regularly for current program details and updates.

INSuRANCERegistration fees do not include insurance of any kind. It is strongly recommended that participants take out their own general travel insurance. It is suggested that the insurance policy should also cover loss of fees/deposit, airfares, accommodation charges, medical expenses, loss or damage to personal property and repatriation expenses.

The insurance should cover loss arising from the cancellation of the Conference

by the organisers or a person’s inability to attend due to any reason whatsoever. No responsibility is taken by the Conference managers for any person not holding insurance.

PRIVACy STATEmENTLeishman Associates are Conference and event managers, and are representing the Australasian Military Medicine Association.

When we collect and hold personal information about you, that is, information that can identify you, such as your name, address and other contact details, it will be related to your prospective or confirmed involvement in the Conference.

Generally, we will collect and hold your personal information for the purposes of: providing services to you, to respond to queries made by you, or to keep ourselves and you informed of the status of the Conference or event that you have confirmed your involvement in, or are prospectively attending.

If the personal information you provide to us is incomplete and/or inaccurate, we may be unable to provide you with the services you are seeking.

Only employees of Leishman Associates are privy to your personal information. Sub- contractors do not have access to such information.

For a full version of the Leishman Associates Privacy Policy, please visit the Conference website on www.amma.asn.au/amma2014.

FuRThER INFORmATIONLeanne BleathmanAMMA Conference Manager113 Harrington Street, Hobart, Tas 7000P: 03 62347844 f: 03 6234 [email protected] www.amma.asn.au



RegistRation foRmAUSTRALASIAN MILITARYMEDICINE ASSOCIATIONCONFERENCE 2014


TAX INVOICE ABN: 81 485 060 729

DeleGate DetaIls

RACGP NO: ____________________________________

ACRRM NO: ____________________________________

Title/Rank: ______________________________________

Organisation: ____________________________________

Given Name: ____________________________________

Surname: _______________________________________

Postal Address: __________________________________

Suburb: ________________________________________

State: ________________________ Post Code: ________

Country (if not Australia): ___________________________

Business Telephone: ______________________________

Mobile: ________________________________________

Facsimile: ______________________________________

Email: __________________________________________

Special Requirements Dietary: ______________________

_______________________________________________

Special Requirements Access: ______________________

_______________________________________________

If registering as a Student please supply

Student No: _____________________________________

Name of University: _______________________________

prIVaCy Clause

Attendee names will be added to a list of name and organisation details for general distribution to other delegates. If you do not want you name to appear on this list please indicate below.

I do not wish to have my name and contact details on the delegate list

aCCoMpanyInG person

Accompanying Person Name: ________________________

________________________________________________

Special Requirements (dietary/access): ________________

________________________________________________

________________________________________________

________________________________________________

reGIstratIon (please indicate which cost/ type of registration applies)

early bird rates apply before 1 august 2014

registration fees

Full Registration Early Bird Standard

Member $850 $950




Retired Member $695 $775

Day Registration Early Bird Standard

Member $375 $425




Retired Member $250 $300

Day Registrants: Please indicate which day(s) you are attending:

Friday Saturday Sunday

If you have been accepted as a speaker at the conference you are entitled to Early Bird rates

speaKer

Full Registration $850

Student Full Registration $695

Day Registration $375

Student Day Registration $250

Speaker Day Registrants: Please indicate which day you are presenting:

Friday Saturday Sunday

Please complete and return with payment* to:

Australasian Military Medicine Association113 Harrington Street HOBART TAS 7000

Fax: (03) 6234 5958





entItleMents

Full Registration for members and non-members includes attendance at all sessions during days of Friday 17 - Sunday 19 October 2014. Full registration also includes; one set of Conference proceedings, satchel, name badge, lunch, morning and afternoon refreshments and entry to the Welcome to Adelaide Reception, Conference Welcome Reception & Conference Dinner. You will have an opportunity later in the form to purchase additional tickets to the social functions.

Day Registration includes attendance at sessions on the nominated day of attendance, one set of Conference proceedings, satchel, name badge, lunch, morning and afternoon refreshments on the day of attendance. Day registration does not include any of the social program functions. Tickets to attend any of the social functions need to be purchased separately.

I am attending the Conference Welcome Reception on Friday 17 October

I am attending the Conference Dinner on Saturday 18 October

soCIal proGraM optIons

Additional places for Social Activities are available for day delegates, partners or friends, please indicate in the box how many additional tickets you require for:

Welcome Function - $80

Conference Dinner - $190

Includes the purchase of _____________ ADDITIONAL Conference dinner guests

Includes the purchase of _____________ ADDITONAL Welcome reception guests

aMMa WorKsHop

To be held on Thursday 16 October 2014, at the Hilton Sydney

Essential Military Musculoskeletal Rehabilitation and Sports Medicine 2014 presented by COL Anthony Delaney (1 day 1000-1730)

AMMA Members - $525

Non Members - $575

A DISCOUNT OF $100 WILL BE OFFERED TO THOSE WHO ATTEND A WORKSHOP IN CONJUNCTION WITH A FULL REGISTRATION FOR THE 2014 AMMA ANNUAL CONFERENCE

MetHoD of payMent

Credit Card

Visa MasterCard

Card Number: / / /

Expiry Date: /

Cardholder Name: _________________________________

Cardholder Signature: ______________________________

Cheque Made to Australasian Military Medicine Association

Direct DepositBank: Australian Defence Force Credit Union

Account Name: Australian Military Medicine Association

BSB: 642 170

Account Number: 100173591

Swift: CUSCAU2SXXX642170

total fees payable: $ _________________________

When making payment please use a reference number that specifies Conference payment (CF-14) in addition to your last name. Please fax remittance to 03 6234 5958 or email [email protected]

aCCoMMoDatIon

A credit card number is required to secure your booking, please provide details of this card below. Leishman Associates will not deduct any funds from this card for accommodation. The number is supplied to the hotel to secure the room only and will be deducted on departure. For more information on accommodation, please see the AMMA website www.amma.asn.au/amma2014 or page 9 of this brochure.

Name of Hotel: ____________________________________

Room Type: ______________________________________

Arrival Day and Date: ______________________________

Departure Day and Date: ____________________________

Name of person sharing with (if applicable): _____________

________________________________________________

accommodation Credit Card payment

Visa MasterCard

Card Number: / / /

Expiry Date: /

Cardholder Name: _________________________________

Cardholder Signature: ______________________________

In the interests of reducing the Conference impact on the environment it would be appreciated if you could register online at www.amma.asn.au. If you wish to fax the registration form, please print the registration form only.





Documents

CONFERENCE 2014 - AMMA