Welcome to the 2017 Lasallian Women's Symposium Registration Form
To register for the 2017 Women's Symposium being held in Auckland, New Zealand from Sunday, 16 July to Wednesday, 19 July 2017, please complete the form below:
Name (First and Last Name):
Your answer
Preferred Name:
Your answer
Name of Lasallian Workplace:
Your answer
Your role:
Your answer
Preferred way to receive Symposium Information:
If your preferred way to receive Symposium Information is by postal mail, please list your address below:
Your answer
If your preferred way to receive Symposium Information is by email, please list your email address below:
Your answer
Person to contact in the event of an Emergency (name and telephone number):
Your answer
Do you have any special dietary requirements:
Do you have any needs:
If you listed Other above, please indicate below:-
Your answer
The Conference Cost is $1200.00 This includes all meals, conference materials, activities and three nights accommodation. It does not include alcoholic drinks, or personal expenses such as phone calls or internet. Included in this cost is Hotel accommodation valued at $660.00 (private room) for the three nights of the Symposium. Should you wish to share a room (twin share), the total Conference Cost will be reduced to $870.00. Please list your ACCOMMODATION PREFERENCE BELOW:
If you are sharing a room, is there a person you would like to nominate to share with. Please indicate their name below:
Your answer
Do you agree to pay the Conference Costs? (An invoice will be sent to your nominated email address)
If you require financial assistance, please email Julie Alibrandi, Operations Manager, Lasallian Mission Services at juliealibrandi@delasalle.org.au or by postal mail to Julie Alibrandi, 26 Meredith Street, Bankstown NSW 2200, Australia.
Your answer
Thank you for completing this Registration Form.
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms