APNS National Conference 2019

APNS National Conference 2019

Monday & Tuesday 29-30 July 2019
REGISTRATION FORM

(NB: please complete a separate form for each delegate)
Name*

TitleFirst NameLast Name
Organisation*
Address*

Street Address

Street Address Line 2

CityState

Post Code
E-mail*
Phone / Mobile*
Please click: *

Please share my information with other delegatesI do not wish to share my information
Please advise of any special dietary requirements:
I will be attending the APNS National Conference 2019 as:*

APNS Member rate $550Non-APNS Member rate $790Dinner Monday night $80 per person
Total cost $
NB: Registration fee includes refreshments and lunch both days at the spectacular Sofitel Surfers Paradise Broadbeach Hotel, QLD
Please make payment via EFT to:

Association of Private Nursing Services BSB 082201 A/C 58 6267377 - ‘Reference’ NC2019 + your business name.

Please email your EFT remittance receipt to sarah@entwistle.com.au

Please register by Monday 15 July 2019
Enter the message as it's shown*
Should be Empty: