Enquiry Form

Business/Organisation Name:

Event Name:

Contact Name:

First Name

Last Name

Personal Title

Email Address:

Street Address:

Street

Suburb:

Postcode

Postal Address:

Street

Suburb:

Postcode

Phone Number:

Fax Number:

Event Type:

Gala dinner/banquet Convention/Meeting Concert Exhibition Other, please specify

Other

Preferred dates of Event:

Start Date (dd/mm/yyyy)

End Date (dd/mm/yyyy)

Number of estimated attendees:

Comments:

Please send me an information kit:

How did you find out about the Centre?

Referral by colleague Townsville Enterprise Convention Bureau Advertising/direct mail campaign Previous delegate Other, please specify

Other

How would you prefer to be contacted:

Email Phone Fax