Events Booking

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rand
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Is COH
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activity_code
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Activity_SF_Code
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location
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event_year
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topiccat
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topic
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organiser
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core_related
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eventid
YOU ARE BOOKING FOR:
AIOH Chapter Meeting - Western Australia - October 2024
Are you booking on behalf of someone else?
- NO
- YES
Your Name**
Attendee Name**
First Name Last Name
Email Address**
Enter Email Confirm Email
Purchase order # If applicable**
Add Purchase order number or type NA if not applicable
Company**
Job Title**
Home Street Address**
Are you overseas? Select your country first.
Home City/Suburb**
Home State**
Select your country if outside Australia.
Home Postcode/ZIP**
Please specify your State/Region**
Country**
Country
Mobile Number**
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**
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**
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**
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**
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**
Discount Code
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% Discount
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GST_action
PLEASE SELECT TICKET (Members Options)
Prices EXCLUDE GST
PLEASE SELECT TICKET
Prices EXCLUDE GST
Discount
Price: $ 0.00
GST
Price: $ 0.00
TOTAL PAYABLE TODAY
$ 0.00
Total includes GST
COMPLIMENTARY AIOH MEMBERSHIP
- YES
Booking the BPOH through the AIOH, you will receive a complimentary AIOH Associate membership for 12 months. This includes wavering the AIOH joining fee. Once processed our Membership Manager will be in contact with your membership details. NB: Membership is compliment for 12 months from the date of processing, Annual Subscriptions will be invoiced annually as outlined in your welcome letter.
Your consent**
- TICK TO ACKNOWLEDGE
That you have read the comprehensive guide to applying for AIOH Membership and accept the terms & conditions of membership (download). You also agree to have your application details saved on the AIOH database.
Date of birth**
YYYY
MM
DD
Gender**
Work Street Address**
Work City/Suburb**
Work State**
Select your country if outside Australia.
Please specify your State/Region**
Work Postcode/ZIP**
Country**
Country
Industry Sector**
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Ticket_Code
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ticket_cost
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cm_points
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oktopay
PAY BY CREDIT CARD (eWay)**

American Express
MasterCard
Visa
Supported Credit Cards: American Express, MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name
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Salesforce ID
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NoSalesforce
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activity_type
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COH_Category
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COH_SubCategory
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Current Membership
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StartDate
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Ticket_Code_member
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ticket_cost_member
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Ticket_Code_general
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ticket_cost_general
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today_date**
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Ticket_Name
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Email Message
Email
This field is for validation purposes and should be left unchanged.