The 2020 Australian SRV Gathering - Online Registration Form

The 2020 Australian SRV Gathering: SRV in action

Please fill in the form below. One per person please.
Key Dates - Please DON'T book flights & accommodation until you receive confirmation from us

6 December 2019 - Earlybird Registrations Close

17 January 2020 - Standard Registrations Close

Rego's after 17 January 2020 attract a 10% late fee above the Standard Rego

27 January 2020 - Latest confirmation of your Registration
Full Name *

First Name Last Name

Address *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

email - must be attendees email address *
Phone Number *

Area Code Phone Number
What role/s are you attending the Conference in? You can choose more than one.

Personal Family Member Support Worker Coordinator/Manager HR/Finance/Communications Educator
Organisation
Essential dietary requirements
Type a question
I agree to my name and email address appearing on the list of attendees, in order to strengthen the network of those who use SRV.

Yes No
I will attend:

Event - 27-28 March 2020 Dinner - 6:30pm on 27 March 2020
REGISTRATION COSTS EPLAINED:

Standard: This rate is for professionals or people with a disability and families who are attending who are employed by or represent a service, support or advocacy organisation, company or corporation.

Agency Sponsored: This rate is for agencies who wish to either sponsor people with a disability or families who use the services of their organisation.

Concession: This rate is for people with a disability, families, and Health Care Card holders who are paying as an individual from their own resources.

Student (Full-Time): This rate is for students who are studying full-time. A copy of a current student card must be provided.

Student (Part-Time): This rate is for students who are studying part-time. A copy of a current student card must be provided.

Companion Card: Must be produced if supporting a person with a disability to attend.
YOUR REGISTRATION WILL GIVE YOU ACCESS TO:

SRV and SRV-related materials

presentation handouts

lunches and morning and afternoon teas

others who use SRV

the opportunity to build develop genuine, ongoing relationships with others who use SRV

publications for sale
A limited number of 1-day tickets are available for family members - email viaainc@gmail.com
Please select payment option

By Direct Deposit By Cheque
Cheque: Please make cheques payable to Values in Action Assoc Inc. and post to Values in Action, PO Box 1247, MILTON BC, 4064

By Direct Deposit:

MUST include name of PARTICIPANT on deposit transaction:

Suncorp-Metway

Account Name: Values in Action Association Inc
BSB: 484-799 Account No. 0414 77931.

Please send us advice of the deposit so your payment is not lost.
Please select Registration Type
EARLYBIRD (this form and payment due 6/12/19) Choose your registration type

Standard - $330 Agency Sponsored - $235 Concession - $170 Student FT - $150 Student PT - $250 Companion Card Holder - $0 DINNER - $50
REGULAR (this form and payment due 17/1/20) Choose your registration type

Standard - $390 Agency Sponsored - $290 Concession - $210 Student FT - $190 Student PT - $300 Companion Card Holder - $0 DINNER - $50
Please tick if you require an invoice to be sent to you.

Type option 1
WHEN WILL YOU RECEIVE CONFIRMATION OF REGISTRATION?

Earlybird registrants will receive a 'confirmation of your place' email by 20 December, 2019. Those registering later than 6 Dec will receive a 'confirmation of your place' email no later than 27 January, 2020.

If you have not received your confirmation, please contact the Event Coordinator Greg Mackay: viaainc@gmail.com or call 0481 216 993.

VENUE:
This 2020 Australian SRV Gathering will be held at

Virginia International, 21 Zillmere Rd, Boondall, 4034 - accommodation on-site -quote ‘SRV’ for discount

https://brisbaneinternationalhotels.com.au/

Free Parking is available on site.

RSVP:

6 December 2019 - Earlybird Registrations Close

17 January 2020 - Standard Registrations Close

Rego's after 17 January 2020 attract a 10% late fee

27 January 2020 - Latest confirmation of your Registration

CANCELLATION POLICY:

If a cancellation is made:

2+ weeks before the event, a full refund will be given
Within 2 weeks of the event, a 50% refund will be given
However, in all cases, an eligible substitute registrant may attend.
Should be Empty:

Now create your own JotForm - It's free! Create your own JotForm

The 2020 Australian SRV Gathering: SRV in action