South East Esperanto Club

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ENROLMENT FORM FOR 24th AUSTRALIAN  ESPERANTO SUMMER SCHOOL
Between Sunday 11th January and Sunday 25th January 2009 (14days+nights)
Please use one form per person. Print in capital letters and send the form to:
24th AUSTRALIAN ESPERANTO SUMMER SCHOOL 2009
Mr. Alan Turvey, 2 Knight Close, Ourimbah, NSW 2258
Telephone +61(0) 2 4362 8287, e-mail <jaba@pacific.net.au>

Title____ Family name__________________________Personal name___________________________
Name for the name-tag___________________________________Age___________________________
Address ______________________________________Postcode_________Country________________
Telephone numbers (daytime) ____________________________(evening) _______________________
e-mail address________________________________________________________________________
Enclosing payment for the course and/or 10% deposit for accommodation (non-returnable), I confirm
my registration for the 24th Australian Esperanto Summer School.

Course (external room)AEA member $455/concession $380 or $545/455 after 1/12/2008.   $__________
Course(external room) Non-AEA member $500/concession $420 or $600/$505  after 1/12/2008.   $_______
Room (no course)AEA member (room only) daily $91/concession $83  or   $109/$100 after 1/12/2008
                                                                                            Number of days_____$_____________       
Room (no course)Non-AEA member (room only) daily $100/concession $91 or  $120/$109 after 1/12/2008 
                                       Number of days______$____________
All (course and room) AEA member$1,390/concession $1,350. or  $1,670/$1,620 after 1/12/2008 
                                                                                                                                          $_____________            
All (course and room) Non-AEA member $1,530/concession $1,485 or  $1,835/$1,780 after 1/12/2008
                                                  $_____________
Extra days for ‘All’ per day, AEA member $76/concession $74 or  $91/$89 after 1/12/2008
                                     Number of days______$_____________
Extra days for ‘All’ per day Non-AEA member $91/concession $83 or $109/$100 after1/12/2008
                                     Number of days______$_____________
Family rates: contact aesk@esperanto.org.au
TOTAL COST $_____________________      AMOUNT ENCLOSED ____________________________

Date of first night_______________ Date of  last night_______________
I am paying  $____________ by cheque enclosed.
I am paying $____________ directly to the CBA bank account, AEA Summer School, BSB 063-138,
                       Account number 1035 3462
I am paying $_____________ by PayPal_(libroservo@esperanto.org.au)
Cancellations: We shall retain 10% of your payment for administration after…1/12/2008

I am a lacto-____________ vegan  _______________  vegetarian
I need gluten-free________dairy-free food_________
My special problems are (eg.health):
________________________________________________________________________
I intend to join the following: (underline and show your first and second preferences)
Childrens’ Group (beginners)
Level 1 (real beginners)                                                Level 2 (after beginners)
Level 3 (intermediates)                                                 Level 4 (advanced)
I intend to start work on the ‘Elementa’                      ‘la Supera’ examination

Date ______________________________ Signature__________________________________

The Australian Esperanto Summer School
2009