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Conference Registration

Registration Form

Please fill out the form below to register for the conference. All fields are required unless otherwise indicated.

Personal Information

Title
First Name
Last Name
Mobile Phone Number
Email Address
Confirm Email Address
Dietary Requirements
Special Needs
Are you a STAV Member? Yes No
STAV Membership Number
Are you attending/planning to attend STAVCON? Yes No
If you're planning to attend and haven't already done so, please register for STAVCON at http://www.sciencevictoria.com.au/STAVCON.html
Which days of STAVCON are you attending? None Thursday Friday Both
Will you need a 1 day parking permit for the 27th? Yes No

School/Organisation Information

Your Position
School/Organisation
Address Line 1
Address Line 2
City/Suburb
State
Post Code
Business Phone (including area code)
Business Fax (including area code)
School Type
School Region
School Level

Travel Information

Are you travelling from interstate or regional Victoria? Yes (Interstate)
Yes (Regional)
No
Will you require accommodation? Yes No
If you require accommodation, how many nights will you require?
Will your school require Casual Relief Teaching during your absence? Yes No
If you require teaching relief, how many units of CRT will your school require?