PDCN Workshop Registration

Organisation Name(Required)

Organisation Billing Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Your Name(Required)

First Last

Your Email Address(Required)

Contact Phone Number(Required)

How many people will be attending?(Required)

1-3 people ($130+GST per person)

More than 4 people ($110+GST per person)

Disability Inclusion Workshop (1-3 people)

Price:

Please tell us exactly how many people you would like to register(Required)

Disability Inclusion Workshop (4 or more people)

Price:

Please tell us exactly how many people you would like to register(Required)

Total

Total price displayed above excludes GST. The invoice you receive will include GST.

Please provide the full names of all attendees(Required)

Please detail any access or communication requirements for attendees

Morning/afternoon tea will be provided. Please detail any dietary requirements for attendees

Name

This field is for validation purposes and should be left unchanged.

Disability Inclusion Workshop Registration Form