NON-MEMBER REGISTRATION FORM <GO BACK TO MAIN PAGE CONTACT DETAILSName* First Last Position* Organisation* Email* Phone*CONFERENCEWhile we welcome non-Members to our conference we do have the right to refuse registrations by any competitors or organisations that fall outside the Local Government sector. I agree Please outline why you are interested in attending the Statewide Mutual Risk Management Conference Would you like to attend both days of the conference?*Thursday 29th and Friday 30th August 2018YesNoIf not, which day will you be attending?*Thursday onlyFriday onlyWORKSHOPSPlease indicate which Workshop you would like to attend on Day 1, Thursday 29th August: WORKSHOP 1 Tree Management - 3pm to 4:30pm WORKSHOP 2 Claims Handling - 3pm to 4:30pm Please indicate which Workshop you would like to attend on Day 2, Friday 30th August: WORKSHOP 3 Contractor Management - 9am to 10:45am WORKSHOP 4 Climate Change - 9am to 10:45am WORKSHOP 5 Property Preparation and Protection - 9am to 10:45am Do you require a Certificate of Attendance to be sent to you to enable you to claim CPD points?YesNoDINNERWould you like to attend the Conference Dinner?*Held on Thursday 29th August at The Sofitel Wentworth, SydneyYesNoDIETARY REQUIREMENTSDo you have any dietary requirements?None at allGluten FreeDairy FreeVegetarianOTHERPlease outline any other dietary requirements you have and we will endeavour to address these.* PAYMENTThe cost to attend the conference as a non-Member is $600 (inc GST) for the 2 day conference and $160 (inc GST) for the dinner.Invoice options*Please tick the items to be included in your invoice. I will be attending 1 day of the conference ($300 inc GST) I will be attending the full 2 days of the conference ($600 inc GST) I will be attending the conference dinner ($160 inc GST) I am a QLD LGM Liability Member (you will be invoiced the Member rate of $495 (inc GST) for the 2 day conference and $160 (inc GST) for the dinner.) Invoice options for QLD LGM Liability MembersPlease note Statewide Mutual is delighted to offer QLD LGM Liability Members the Member-rate of $495 (inc GST) for the 2 day conference and $160 (inc GST) for the dinner. I will be attending 1 day of the conference ($247 inc GST) I will be attending the full 2 days of the conference ($495 inc GST) I will be attending the conference dinner ($160 inc GST) If the invoice details are different from the above please specify:
