Updating or Amending Information?

If you have already registered and wish to update or amend any information, please check the box already registered below and add your name together with updated information into the form. You can include further instructions in the Additional Information Section at the bottom of the form.

Privacy

Privacy Act: The Privacy Act 2001 provides that before your name and contact details can be published in the list of conference delegates for distribution to fellow delegates or any other party, you must give your consent. Your name and contact email address will be provided to organisers of the next event in this series and to sponsors of the Conference without whose support the event would not be possible. If you agree to the publication of your contact details please check the box.

Personal Details

*required field

 Add dietary or access needs in the text box above.

Registration

Registration Monday 1 - Thursday 4 July, 2018

 Registration Fee Inclusions - Further Information

 Non-members have the opportunity register inclusive of 12 months ANZAHPE membership. If you wish to take advantage of this option, you must select "Full Non-Member incl. membership" below and then complete your profile for the member database at https://form.jotform.co/72220676984868 Your name/email address will be passed on to the ANZAHPE Secretariat who will confirm membership.
If you have one, enter your discount code here.

Social Program

Welcome Reception Monday 1 July 2019

Conference Dinner Wednesday 3 July 2019

 Full registration includes one Welcome Reception and one Dinner ticket. For planning purposes please indicate if you are not attending. Tickets are an additional cost for guests and day registrants.

Payment

 Payment is by cheque, direct bank transfer or credit card (Visa, MasterCard and AMEX accepted).

Payment Instructions

Credit card transactions will appear on your credit card statement as Plevin and Associates Pty Ltd

Please ensure that all bank transfer payments include clear reference to the delegate name and organization.

Cancellation Policy

All cancellations must be submitted in writing. Cancellations of registration received on or before Monday 17 June 2019 will incur a fee of $100. No registration refunds will be made for cancellations received after this date. As an alternative to cancellation, your registration may be transferred to another person.

Additional Information

Add any additional instructions or requests.

Submission Instructions

Check that you have completed the form correctly. Print a copy for your records and then press the submit button.