FPOA ASAD 2018 | DELEGATE REGISTRATION FORM

We welcome your registration for the FPOA ASAD Conference 2018. It is important to read all the information on the website before you commence.  Please note all prices quoted are in Australian dollars (AUD) and are inclusive of 10% goods and services tax (GST). 

Instructions for Online Registration    

  • All information should be typed in upper and lower case (e.g. John Smith)
  • Please use the ‘Tab’ key to move from one field to the next 
  • As you complete the details on each page, click ‘Next’ to proceed to the next section
  • You will have the opportunity to review and edit your registration details before the final stage of confirmation and payment
  • Internet Explorer and Google Chrome are the preferred platforms for use of the forms
Delegate Contact Details
Conference Name Badge

Please advise of your preferred first name and last name to be printed on your conference name badge:

DELEGATE LIST

A delegate list will be provided electronically to all delegates and participating supporters and exhibitors. The list will include the name, organisation and state/country of delegates who have consented to their information being included on the list and have registered at the time of distribution.  If you do not wish to have your details included on this list, please indicate below:
REGISTRATION OPTIONS

Please indicate below your applicable registration category.

Please note the early bird registration fees apply to registrations received and paid in full on or before Monday 20 August 2018.

AUD$

FULL REGISTRATIONS

Include:
Access to conference sessions, exhibition, daily catering, Welcome Reception and name badge.

NOTE: Tickets to the Conference Dinner are available to purchase at an additional cost.
FPOA Member
800.00
900.00

CATEGORY A, B or C
Please refer to the list of countries defined by the world bank by clicking here, to identify your applicable category (from categories A, B or C listed below).
ASAD Member
800.00
900.00
640.00
720.00
475.00
575.00
Non-Member
830.00
935.00
660.00
745.00
500.00
560.00
Trainee
475.00
540.00
475.00
540.00
Other
525.00
575.00
265.00
DAY REGISTRATIONS
Include:
Access to conference sessions, exhibition and catering on the specified day and name badge.

NOTE: Tickets to the Welcome Reception and Conference Dinner are available to purchase at an additional cost.


Please specify which day/s you will be attending the conference below:

FPOA Member
470.00
470.00
470.00

CATEGORY A, B or C
Please refer to the list of countries defined by the world bank by clicking here, to identify your applicable category (from categories A, B or C listed below).

ASAD Member
470.00
470.00
470.00
380.00
380.00
380.00
290.00
290.00
290.00
Non-Member
505.00
505.00
505.00
400.00
400.00
400.00
300.00
300.00
300.00
Trainee
290.00
290.00
290.00
475.00
475.00
475.00
Other
315.00
315.00
315.00
160.00
160.00
160.00
PRE-CONFERENCE WORKSHOPS ONLY

For non-delegates who will be attending the pre-conference workshops only, on Wednesday 7 November 2018.

Please select this registration option if you will be attending the Advanced Trainee Day on Saturday 10 November 2018; which will run concurrently to the conference program.

RANZCP MEMBERSHIP NUMBER
Please provide your RANZCP membership number below:
PROOF OF STUDENT ELIGIBILITY
Please upload your proof of student eligibility below:
PRE-CONFERENCE WORKSHOPS

Pre-Conference Workshops are offered to delegates prior to the conference on Wednesday 7 November 2018 at Crown Promenade. As numbers are strictly limited, we encourage you to book these early. Further information regarding the pre-conference workshops can be found on the website.

You have the option to attend ONE pre-conference workshop.

Please also select this registration option if you wish to attend the Advanced Trainee Day held after the conference on Saturday 10 November 2018.

AUD$

Pre-Conference Workshop 1: Neuroimaging, 0900-1700 (full day)
Presented by Dr John O’Brien
Date: Nov 07, 2018 Time: 0900 - 1700
360.00
Pre-Conference Workshop 2: The Neuropsychiatry of Parkinson’s and Huntington’s Disease, Wednesday 7 November 2018, 0900-1230 (half day)
Presented by the Melbourne Neuropsychiatry Unit
Date: Nov 07, 2018 Time: 0900 - 1230
190.00
ADVANCED TRAINEE DAY

In addition to the conference program, an Advanced Trainee Day will be offered to trainees attending the conference on Saturday 10 November 2018 at Crown Promenade. As numbers are limited we encourage you to book early. Further information regarding this workshop can be found on the website.

AUD$

Advanced Trainee Day, 0900-1230
Date: Nov 10, 2018 Time: 0900 - 1230
360.00
SOCIAL PROGRAM

You are invited to participate in the conference social program. Further information can be found on the website. Please indicate your participation below:

NOTE: The Welcome Reception is included in all full registrations. Additional tickets may be purchased for the Welcome Reception by nominating the number of tickets required. 

AUD$

Welcome Reception, Thursday 8 November 2018, 1700-1830
Venue: Tonic Bar, Crown Promenade
Date: Nov 08, 2018 Time: 1700 - 1830


70.00
Conference Dinner, Friday 9 November 2018, 1900-2200
Venue: Alto Room, The Langham Melbourne
Date: Nov 09, 2018 Time: 1900 - 2200
150.00
SOCIAL PROGRAM

You are invited to participate in the conference social program. Further information can be found on the website. Please indicate your participation below:

AUD$

Welcome Reception, Thursday 8 November 2018, 1700-1830
Venue: Tonic Bar, Crown Promenade
Date: Nov 08, 2018 Time: 1700 - 1830
70.00
Conference Dinner, Friday 9 November 2018, 1900-2200
Venue: Alto Room, The Langham Melbourne
Date: Nov 09, 2018 Time: 1900 - 2200
150.00
REGISTRATION QUERIES / SPECIAL REQUIREMENTS
Special Dietary Requirements
Mobility Requirements
Registration Queries
SUMMARY


Please review these details carefully. Should you wish to make changes, click ‘Edit’ on the section(s) you wish to change. 

Once you are satisfied the information reflects your registration requirements, please review the Cancellation/Refund Terms and Conditions and indicate your agreement to these below. You will then proceed to the payment page.

Cancellation/Refund Terms and Conditions

Cancellation of a registration must be advised via email to the Conference Office.  Verbal changes or cancellation cannot be accepted. 

The following refunds will apply from the date of receipt of notification: 
On or before Tuesday 7 August 2018: 100% refund less an administration fee of $110 including GST
On or before Friday 7 September 2018: 75% refund less an administration fee of $110 including GST 
On or before Sunday 7 October 2018: 50% refund less an administration fee of $110 including GST
After Monday 8 October 2018: No refund available

The refund will be returned via the same payment method as the original receipt of funds. 

No refund will be made after Monday 8 October 2018 however an alternative delegate name may be provided in writing and the booking and funds will be allocated accordingly. 

Please note no refund or discount will be made if a function or event within the registration fee is not taken up or is subsequently cancelled. 

Optional functions, workshops or events may be cancelled before or on Tuesday 7 October 2018 and will be refunded in full via the same payment method as the original receipt of funds. After Monday 8 October 2018 no refunds will be made however an alternative delegate name may be provided via email and the booking and funds will be allocated accordingly. 

Please indicate below your acceptance of the Cancellation/Refund Terms and Conditions, then press ‘Next’ to proceed to the payment page.
Terms and Conditions
PAYMENT

REGISTRATION PAYMENT

  • Online registrations can be paid by credit card (Visa, Mastercard and American Express), by cheque (drawn on an Australian bank only), money order or payment via electronic funds transfer
  • If payment is made by an international electronic funds transfer please include an additional AUD$25 to cover the local bank fee 
  • Please note if a registration is made less than 30 days prior to the event, Monday 8 October 2018, credit card is the only payment option available
  • Participation is not confirmed until full payment is received
  • Please note ‘WALDRONSMITH Management’ will appear on your credit card transaction statement


PAYMENT OPTIONS

Credit Card: 

Visa, Mastercard and American Express are accepted
Note: From Monday 8 October 2018 all online registrations must be paid in full by credit card.

THANK YOU


Thank you for registering for the FPOA ASAD 2018 Conference. Your registration and payment details have been forwarded to the Conference Office and you will receive a confirmation via email shortly. 

If you have any queries regarding your registration please contact the Conference Office below. 


FPOA ASAD 2018 Conference Office: 

C/O WALDRONSMITH Management
119 Buckhurst Street
South Melbourne VIC 3205 Australia
T  +61 3 9645 6311  
F  +61 3 9645 6322 
E  fpoaasad@wsm.com.au
W https://www.fpoaasad.com.au

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