2021 Conference Delegate Registration Form 2021 Delegate Registration Form Registration detailsPLEASE NOTE: A separate form must be completed for each delegate. Name* First Last Email* Enter Email Confirm Email Preferred Phone Number*Including area code, and if outside Australia, country code. HiddenAlternative Phone NumberIncluding area code, and if outside Australia, country code. Name for Conference*Please enter your name as you would like it listed in the delegate list. Organisation Postal Address (line 1)* Postal Address (line 2) Town/City* State/Province* Postcode* Country* Conference InformationIn order to reduce our environmental footprint, the Round Table Conference is a ‘Paperless Conference’. Conference papers will be available in accessible formats on our website prior to the conference. If for any reason, you are unable to access this information please contact the Administration Officer by email at admin@printdisability.org. Please provide details of any accessibility requirements.Membership Status*Please enter your membership statusI am a Round Table memberI am not a Round Table memberI am a self-funded consumerHiddenConference registration options (Round Table members)*selected days and eventsHiddenConference registration options (Non-Round Table members)*selected days and eventsHiddenConference registration options (Self-funded consumers)*selected days and eventsSelected days and events (Members)* IMPORTANT: Please check ALL the days and events you will be attending from the selection below. ABA General Meeting 2 Day Conference Proper 3D Printing tutorial Producing Accessible Graphics workshop Braille Music Production workshop AGM Selected days and events (Non-Round Table Members)* IMPORTANT: Please check ALL the days and events you will be attending from the selection below. ABA General Meeting 2 Day Conference Proper 3D Printing tutorial Producing Accessible Graphics workshop Braille Music Production workshop AGM Selected days and events (Self-funded consumers)* IMPORTANT: Please check ALL the days and events you will be attending from the selection below. ABA General Meeting 2 Day Conference Proper 3D Printing tutorial Producing Accessible Graphics workshop Braille Music Productionworkshop AGM Permission To Share Contact DetailsIn registering for this Conference, relevant registration details (name, organisation and email address) will be incorporated into a delegate list for the benefit of all delegates, and may also be made available to parties directly related to the Conference. By registering, delegates consent to the collection, use and disclosure of information provided in this registration form in accordance with and for the purpose outlined above. When registering for the conference delegates also give permission for Round Table on Information Access for People with Print Disabilities to use their name on the Round Table website and in any Round Table publication.IMPORTANT: If you DO NOT AGREE to the above please indicate by selecting the appropriate option below: I do not consent to the collection, use and disclosure of information provided in the registration form in accordance with and for the purposes outlined above. I do not give permission for Round Table on Information Access for People with Print Disabilities to use my name taken at the conference on the Round Table website or in Round Table publications. Total $ 0.00 Payment Methods*Direct deposit to Round Table’s bank account at the National Australia Bank (preferred) Swift Code: NATAAU3303M (where applicable for overseas transfer) BSB Number: 083 522 Account Number: 45 742 1243 Account Name: Round Table on Information Access Please clearly identify your deposit with the name of the conference delegate Credit Card or PayPalIf you select Credit Card/PayPal you will be re-directed to the payment page on the PayPal website where you can either use your PayPal account to pay or pay by credit card without signing up for a PayPal account.Direct Credit to Round Table Bank AccountCredit Card or PayPalOnce you have submitted your registration please do not close your browser until the registration is complete and an acknowledgement appears. Last updated: June 2, 2021 at 8:48 am