8th NATIONAL DB CONFERENCE, 28-30 April 2010

Please complete one form per person.

Personal Details: * = required fields/info

Title

(Select) Dr Mr Mrs Ms Miss Other

First Name *

Last Name *

If you are registering through an organisation please make sure you include your Position and Organisation.

Position

Organisation

Address *

Suburb/City *

State *

(Select) Australia Capital Territory New South Wales Northern Territory Queensland Tasmania South Australia Victoria Western Australia Other / Outside Australia

Post Code *

Country

Phone *

Mobile

Fax

Email *

Registration Options & Fees:

The following is included in your registration (for the day/s registered):

• Entry to all conference sessions
• Morning & Afternoon Teas, plus Lunch
• Entry to the Trade Exhibition
• 1 x Conference Satchel & notes

Please select your registration type below:

Attendee Type
General Delegate - People who are deafblind, family, carers and students only
Professional Delegate - Service providers, healthcare professionals, educators, plus all others

Registration Rate: Standard - paid after 13th February, 2010

Days Attending
Full Registration (3 days)

Or, select day(s):

*A 10% Group discount applies if 10 or more deafblind delegates register through the one deafblind services provider. Group discounts can only be received via the hard copy Registration Form. The name of the service provider you belong to must be written on top of form.

Download Registration Form

Total fee for Registrations: $0.00

Optional Social Functions

Please indicate the activities you would like to participate in at the Conference:

Pre-conference Cocktail Party, Tues 27th April 2010 - $45.00 per person
Yes I would like to attend. Number of tickets required:
No I will not be attending the Cocktail Party

Total for Cocktail Party: $0.00

Gala Dinner "Masquerade Ball", Thurs 29th April 2010 - $110.00 per person (limited places apply)
Yes I would like to attend. Number of tickets required:
No I will not be attending the Gala Dinner

Total for Gala Dinner: $0.00

Activities for Deafblind People (incl family and carers), Fri 30th April 2010 - $30.00 per person

Please choose one option only.

Total for Activities for Deafblind People: $0.00

Total for all Social Activities: $0.00

Special Requirements

Please let us know if you will have any special requirements at the conference:

Auslan Interpreter
Tactile Interpreter
Interpreting Table
Deafblind Finger Spelling
Assistance from a Sighted Guide
Note Taker
Conference notes in Large Print
Conference notes in Braille
Live Captioning
Hearing Loop
Assistance with Guide Dog. Please specify details:

Transport assistance required. Please specify:

Special dietary requirements:

Other requirements / relevant information:

Payment Summary

Conference Registration Total:

$0.00

Social Functions Total:

$0.00

Grand Total:

$0.00

Payment Method

Please note, full payment is required with your registration. All registrations will be acknowledged in writing within seven (7) days of receipt of payment.

Direct Deposit / Eftpos to:

Bendigo Bank
Account Name: Able Australia Services
BSB 633 000
Account Number 1155 99 839

Cheque made payable to Able Australia

Please charge my credit card for the above amount

When paying by credit card, you will be taken to PayPal's website to complete the transaction.

Cancellation Policy

Cancellations must be received in writing. A 15% cancellation fee will be applicable for cancellations received 2 months prior to the conference. A 50% cancellation fee will be applicable for cancellations received 1 month to 2 months before the conference. No refunds will be issued for cancellations received less than 1 month before the conference.

Privacy:

In registering for the conference, relevant details may be forwarded onto the organising committee. We will also provide a Delegates List at the conference for networking purposes.
If you do not wish your details to be forwarded, please click this box

Accomodation:

Attendees will be responsible for looking their own accomodation for the conference. Please refer to our accomodation section for recommended hotels.

Enquiries:

Able Australia
616 Riversdale Road
CAMBERWELL VIC 3124
Email: events@ableaustralia.org.au
Phone: 1300 225 369
TTY: (03) 9882 6786