Name:
Address:                                            .
                        Postcode:                   .
Phone:                      Email:                 .

Registration Fee:   $7
Total number of sessions x $2  
(-1 session if pre-registering)

Total Entry Fee:  

I hereby submit my entry and agree to abide by the rules of the Unicon organisers.
 

Signature:                                               .
 
 

Notes: (Scheduling problems and requests):
 
 
 
 
 
 
 

Print this form and send it with a cheque made payable to Capricon to:
 

Unicon,
P.O. Box 47,
Union House,
University of Melbourne
Parkville, Vic., 3052