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2011 Conference
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PERSONAL INFORMATION
Name:
University/Organization
Contact Number:
Email:
Preferred Method of Contact:
Email
Phone
Through my Collective/Organisation
Emergency Contact:
Emergency Contact Number:
FOOD
Do you have any spedific dietary requirements?
Vegan
Vegetarian
Diabetic
Wheat/Gluten-free
Kosher
Halal
Loctose-Intolenrance
Please list any food allergies:
EQUITY
Please list any allergies of health conditions that we may need to know about for your conference comfort and/or any emergencies that may arise:
If you'd like to require any services that will facilitate better access to the conference, please specify: e.g. larger text, physical building access, auslan interpreter
If you'd like to require childcare services during the conference dates, please list the dates this will be required as well as the ages, nams and special requirements for the best possible care of your child:
Would you like to be considered for equity funds? Please let us know how we can help:
ATTENDENCE
Which days of the conference will you be attending?
Monday
Tuesday
Wednesday
Thursday
Friday