Contact Details

* First Name		Preferred Name (for badge)
* Last Name
* Postal Address
* City		* State
* Postcode
Day time phone		Fax
Mobile		* Email

Employer/Workplace Location (for badge)
Special dietary requirements
* Are you a CRANA Member:	Yes No

Conference Events

Full Conference Package	Yes No	$850.00	$650.00
Student Concession Package (Full Time Students ONLY)	Yes No	$350.00	$350.00
Thursday Conference Sessionsonly	Yes No	$350.00	$300.00
Friday Conference Sessions only	Yes No	$350.00	$300.00
Saturday Conference Sessions only	Yes No	$350.00	$300.00
Opening Ceremony only	Yes No	$65.00	$55.00
Conference Dinner only	Yes No	$110.00	$90.00

Optional Pre/Post Conference Events & Workshops

12-14 Oct	Remote Emergency Care (REC)	See Courses Website
18-20 Oct	Maternity Emergency Care (MEC)	See Courses Website
14 Oct	Introduction to Remotea Area Nursing (day session, 9:00am start)	Yes No	$50.00	$50.00
18 Oct	Remote Clinic Site Visit - Hermannsburg (day trip only)	Yes No	$50.00	$50.00

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