Ethnobotanica
IV
Australian Ethnobotany Conference 2004
December 4 & 5, 2004
DO NOT MAIL PAYMENT AFTER NOVEMBER 26. CONTACT US FOR DETAILS
ON LATE PAYMENTS.
info@ethnobotanica.org
Ethnobotanica 2004 Registration Form
All fields are required. Do not leave
any blanks or your registration may be delayed.
NOTE: You must be a "Participating Member" or "Full Member"
of the "Australian Ethnobotanical Conservation Association Inc" to
be able to register.
| First Name (as on photo ID): | |
| Surname (as on photo ID): | |
| What name / nick would you like on your Nametag: | |
| e-mail address (preferred) or phone number : |
| Food preference: (please tick) | ||
| Meat: |
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| Vegetarian: |
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| Vegan: |
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