SA/S-Anon 2019 Queensland Conference Registration
Conference details
Email address *
Contact Details
One Registration form per person. Couples please complete 2 forms.
Given Name *
Your answer
Family Name *
Your answer
Phone number *
Your answer
State *
Your answer
Email Address *
Your answer
Fellowship *
Which fellowship are you a member of? If you are not yet part of either fellowship please email before registering.
SA Members Only: To help us choose speakers and meeting chairs, which sobriety category are you in?
Amount Paid *
Couples can make a single payment but need to complete 2 registration forms.
Payment Method *
Commonwealth Bank : SA Brisbane Intergroup BSB: 064131 Account number: 10439706
If Paying by Direct Deposit what is your payment reference?
eg Mary S Brisbane
Your answer
Are you a snorer? *
Do you require assistance with transport to the venue?
Provide flight or other details
Your answer
Do you have any special needs, eg dietary, wheelchair access, other?
A wide range of dietary requirements and allergies are catered for by the venue.
Your answer
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