Symposium Registration Form

Please complete the following form to register for the Transforming Services – Changing Lives Symposium on Wednesday 15 November 2017.  All persons planning to attend the conference must register in advance. Registration includes lunch, morning and afternoon tea, and the cocktail function.

 

Personal Details

Name

Organisation

Address

Telephone

Mobile

E-mail

Conference Planning

To ensure you are able to fully participate in this conference please complete the following:

I use a Wheelchair
I have a Service Dog
I require Large Print
I require a Hearing Loop
I require a Sign Language Interpreter
Other, Please Specify

Dietary Requirements or Preferences
Gluten Free
Dairy Free
Vegetarian
Vegan
Other, Please Specify

Payment

Cost
$250 Early Bird price till Fri 20 October 2017

$300 Standard price from 21 October 2017

All registrations will be invoiced to the provided e-mail address and are to be paid prior to the event.

Cancellations
A cancellation fee of $50.00 will be applied to any cancellations made prior to 1 November 2017 to cover administration costs. Any refunds after this date will be at the sole discretion of Manawanui InCharge.

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