Community Practitioner Short Course Registration

Registration Form

Preferred Title	Mr Mrs Ms
First Name	required
Last Name	required
Position
Organisation
Mailing Address
State	Please Select Your State ACT NSW NT QLD SA TAS VIC WA
Postcode
Day Telephone	required (please include your area code )
Mobile Phone
Email	required

I am Registering for:	VIC, Bundoora March 24-26 QLD, Riverglenn April 7-9
	Please list any dietary restrictions or other questions here:
Upon Receipt of Registration - you will be sent detailed information on the course content and program, as well as fee payment and accommodation options.
Cancellation Policy	Cancellation prior to 30 days of course commencement: Full Refund
	Cancellation from 30-7 days of course commencement: 50% Refund
	Cancellation within 7 days of course commencement: No Refund