Payment form test I am*Registering myselfRegistering on behalf of someone else or others in my companyEvent name*Event Date*Date Format: DD slash MM slash YYYYdd/mm/yyyyName*FirstLastCompany name*Email*Mobile Number*Number of ticketsAdditional attendees (information)Please include the name, company, email address and mobile number of any additional attendees you would like to purchase tickets for.Dietary requirements*Use of your information*I agree to the below use of informationYour details are collected by the Exhibition and Event Association of Australasia (EEAA) to ensure you are kept up to date with information regarding this event and to contact you on the day if needed. The EEAA will print out an attendee list for delegates, sponsors and speakers who request it with your name and company name only. EEAA will not give out your personal information. The Association will also take photos on the day in which you may be visible. These photos will be used in marketing and in a photo gallery on the EEAA website.Newsletter subscribeI would like to receive communications from EEAA on future events and activitiesEvent ticketPrice:$ 35.00Total$ 0.00Credit Card*American ExpressMasterCardVisaCard NumberExpiration DateMonth010203040506070809101112Year20212022202320242025202620272028202920302031203220332034203520362037203820392040Security Code Cardholder NameCommentsThis field is for validation purposes and should be left unchanged.