2024 Round Table Conference Exhibitor Registration Form 2024 Exhibitor Registration Form Organisation Registration Details Organisation name:* Email* Enter Email Confirm Email Organisation's Web Site Address Preferred Phone Number*Including area code and, if outside of Australia, country code. Alternative Phone NumberIncluding area code and, if outside of Australia, country code. Postal Address (line 1)* Postal Address (line 2) Town/City* State/Province* Postcode* Country* Please provide a brief description about your organisation for inclusion in the Conference Booklet.*Exhibitor Product and Services Information Exhibitors are encouraged to bring product and services information to the conference to display on their stand. Round Table encourages exhibitors to have this information available in alternative formats to meet the needs of the conference audience. Please provide a question (and answer) about your organisation for inclusion in the Conference Quiz.*Please provide a second question (and answer) about your organisation for inclusion in the Conference Quiz.*Round Table requests that each exhibitor supply a prize for the Exhibitor's Quiz. Are you prepared to donate a prize?* Yes No Exhibitor's Quiz Prize Donation*Please provide details of the prize you are prepared to donate for the Exhibitor's Quiz Your contribution will be acknowledged on the quiz form and at the Conference Dinner. Prizes will be awarded at the Conference Dinner. Please reconsider providing a donation for the for the Exhibitor's Quiz All contributions aid in the success of the quiz, which encourages delegates to visit exhibitor's stands. All donated items will be acknowledged on the quiz form and at the Conference Dinner. Prizes do not need to be large items. Please attach an electronic copy of your corporate logo, in JPG format, for inclusion in the final conference program. Suggested size 300 x 300 dpi.*Accepted file types: jpg, Max. file size: 3 MB.Registration Level*There are two levels of exhibitor registration on offer. Level 1 Package ($1250) includes: • Full conference registration for one representative for Sunday, Monday and Tuesday, including lunch on each of these days, the Conference Welcome Function and the Conference Dinner. • A single length display table. Level 2 Package ($2250) includes: • Full conference registration for two representatives for Sunday, Monday and Tuesday including lunch on each of these days, the Conference Welcome Function and the Conference Dinner.• A double length display table.Please indicate the package level you wish to register for: Level 1 Package Level 2 Package STAFF MEMBER REGISTRATION DETAILSName* First Last Email* Enter Email Confirm Email Preferred Phone Number*Including area code and, if outside of Australia, country code. Alternative Phone NumberIncluding area code and, if outside of Australia, country code. Welcome Function Attendance*Do you wish to register for the Welcome Function? This event is being held on Saturday evening and is included in your registration package but must be pre-booked on this form. Yes No Conference Dinner Attendance*Do you wish to register for the Conference Dinner? This event is being held on Monday evening and is included in your registration package but must be pre-booked on this form. Yes No Conference InformationIn order to reduce our environmental footprint, the Round Table Conference is a ‘Paperless Conference’. Conference information will be supplied in accessible electronic formats: - by email to your nominated email address, one week prior to the conference. - for downloading prior to and at the conference (wifi access, within the function area, is included in your conference registration). If for any reason, you are unable to access this information please contact the Administration Officer by email at admin@printdisability.org Please indicate here if you have accessibility requirementsPlease Note: Accessibility requirements may not be able to be considered after 1 April 2018. Venue Orientation Guide Dog Facilities Audio Assistance Wheelchair Access Other (please provide details below) Please provide details of any other accessibility requirements.Special Dietary RequirementsPlease provide details of any special dietary requirements you may have. Vegetarian Vegan Diabetic Gluten Free Other (please provide details below) Please provide details of any other special dietary requirements you may have here.Permission To Share Contact DetailsIn registering for this Conference, relevant registration details (name/organisation/email address and phone number) 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 and photographs taken at the conference on the Round Table website and in any Round Table publication. Please indicate your acceptance of the above permissions by checking the box below.* I consent to the collection, use and disclosure of information provided in the registration form in accordance with and for the purposes outlined above and give permission for Round Table on Information Access for People with Print Disabilities to use my name and photographs taken at the conference on the Round Table website or in Round Table publications. SECOND STAFF MEMBER REGISTRATION FORM Do you wish to register an additional staff member?*An additional staff member registration is included in the Level 2 Exhibitor Registration Package. Yes No Name* First Last Email* Enter Email Confirm Email Preferred Phone Number*Including area code and, if outside of Australia, country code. Alternative Phone NumberIncluding area code and, if outside of Australia, country code. Welcome Function Attendance*Do you wish to register for the Welcome Function? This event is being held on Saturday evening and is included in your registration package but must be pre-booked on this form. Yes No Conference Dinner Attendance*Do you wish to register for the Conference? This event is being held on Saturday evening and is included in your registration package but must be pre-booked on this form. Yes No Conference InformationIn order to reduce our environmental footprint, the Round Table Conference is a ‘Paperless Conference’. Conference information will be supplied in accessible electronic formats: - by email to your nominated email address, one week prior to the conference. - for downloading prior to and at the conference (wifi access, within the function area, is included in your conference registration). If for any reason, you are unable to access this information please contact the Administration Officer by email at admin@printdisability.org. If you require documents, other than those listed below, in alternate formats please feel free to contact us and discuss your requirements. Please consider the environment and order only the information you require in braille or large print. Please indicate if you require the following: Conference Program in braille Delegates Contact List in braille Venue Information in braille Conference Program in large print Delegates contact list in large print venue information in large print Accessibility RequirementsPlease Note: Accessibility requirements may not be able to be considered after 1 April 2018. Venue Orientation Guide Dog Facilities Audio Assistance Wheelchair Access Other (please provide details below) Dietary RequirementsPlease provide details of any special dietary requirements you may have. Vegetarian Vegan Diabetic Gluten Free Other (please provide details below) Please provide details of any other accessibility requirements.Please provide details of any other special dietary requirements you may have here.Permission To Share Contact DetailsIn registering for this Conference, relevant registration details (name/organisation/email address and phone number) 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 and photographs taken at the conference on the Round Table website and in any Round Table publication. Please indicate your acceptance of the above permissions.* I consent to the collection, use and disclosure of information provided in the registration form in accordance with and for the purposes outlined above and give permission for Round Table on Information Access for People with Print Disabilities to use my name and photographs taken at the conference on the Round Table website or in Round Table publications. A double length display table is included in the Level 2 exhibitor's package. Does your organisation require this additional table space?* Yes No Conference Accommodation - Please book directly with the venuePerth Novotel Langley 221 Adelaide Terrace Perth WA 6000 Australia. Bookings to be made directly with the hotel using the accommodation link provided or by phoning or emailing the hotel. Reservations Office (available 9am-5pm Monday-Friday). Quoting block ID 135468 to secure discounted rate. Phone: Tel: (08) 9221 1220 or from overseas +61 8 9221 1220 or Email: valeria.rossi@accor.com Accommodation is subject to availability, so please book early to avoid disappointment. Please notify the staff at the hotel of any special requirements at the time of booking. Please refer to the Round Table website for more details.www.printdisability.org PAYMENTExhibitor Registration Package - L1Level 1 Exhibitor Registration package includes single trestle length display table and registration for one staff member for Sunday, Monday and Tuesday, the Conference Welcome Function and Conference Dinner. Price: Exhibitor Registration Package - L2Level 2 Exhibitor Registration package includes double length display table and registration for two staff members for Sunday, Monday and Tuesday, the Conference Welcome Function and Conference Dinner. Price: Total $ 0.00 Payment Methods*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 deposit to Round Table’s bank account at the National Australia Bank 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 your organisation. Credit Card or PayPalDirect Credit to Round Table Bank AccountOnce you have submitted your registration please do not close your browser until the registration is complete and an acknowledgement appears. Last updated: January 15, 2024 at 13:18 pm
