National Conference

Reforming NDIS
Revolutionising Disability Services

 3-4 September 2018
   

Registration and Payment Form  
 


I wish to register to attend: (please tick one box only)

Both days: Monday 3 September and Tuesday 4 September
One day only: Monday 3 September
One day only: Tuesday 4 September

Please provide the following contact information

Name
Organisation
Work Phone
Email
 Address
Address 
State
Postcode
Country

Please describe your current role and your interest in this event:


TYPE OF REGISTRATION 

Fee (includes GST)

  One
day

 
One
day
Member
CSA
Two
days
 
Two
days
Member
CSA
Individuals, users of services
(self-funded)
$88 $66 $110 $88
Groups (self-help, advocacy,
community with revenue <$500K pa)
$165 $132 $286 $253
Service providers
 
$330 $220 $550 $440
Academics, researchers
 
$330 $220 $550 $440
Commercial (planner, consultant, practitioner, trainer) $330 n/a $550 n/a
 Government
 
$440 n/a $770 n/a

I will be attending as a

         

  I wish to become a member of Civil Society Australia and register at the member rate
  in the following category:

         

Category of Membership - Civil Society Australia
 
Annual Fee
Individuals
Parents and carers; neighbours; consumers; volunteers; residents.
$10
Associations
Voluntary associations; circles of support; sporting clubs; churches; faith groups.
$20
Small businesses
Family farms; family businesses; social enterprises, coops and mutuals.
$30
Services
Schools; health organisations; community services; universities.
$100


  Total amount payable  
 

Payment Options

Please reserve my place and
            
 
I will send my cheque/money order to  Social Enterprise Partnerships
PO Box 159
Yarraville VIC 3013
(Cheque payable to Social Enterprise Partnerships)
OR  
I will pay by EFT transaction:

 

 

Bank: Commonwealth Bank of Australia
Account name: Social Enterprise Partnerships Ltd
BSB: 062 218
Account number: 1007 2945
Please send a tax invoice.

I have read, and accept the terms and conditions described below.

 
 


Terms and Conditions
1. Registration fees must be paid in full before the date of the event.
2. Cancellations must be notified in writing by 24 August, 2018. For cancellations received after 24 August, full fees will apply.
3. Transfer of registration is permitted where necessary, to enable another person from the same organisation to attend the event in place of the person whose name is shown on the registration form. (Should you wish to take up this option, please advise  on the change of name and contact details before the date of the event.)
4. Civil Society Australia reserves to right to accept or reject participants in these events/processes as it sees fit.

Civil Society Australia
Auspiced by Social Enterprise Partnerships Ltd

ABN 47108742098
PO Box 159
Yarraville Vic 3013