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| Title/salutation* | This field is required |
| Family name* | This field is required |
| First name* | This field is required |
| Email address* | Not a valid e-mail address.This field is required |
| Telephone contact* | This field is required |
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| Street number and name | |
| Suburb | |
| State | |
| Postcode | |
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| Employer* | This field is required |
| ABN | |
| Position/title* | This field is required |
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| Tuition fee: | $1,450 (GST exclusive) per person |
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| Early Bird: | $1,250 (GST exclusive) per person |
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| Group Fee (3 or more participants): | $995 (GST exclusive) per person |
| | Please provide the details of other group members via email to sandra.walker@unisa.edu.au |
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Please indicate your
payment preference: | |
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| | Once this form is submitted Sandra Walker will be in contact with you to finalise payment arrangements. |
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| | Sandra Walker: 08 8302 0801 or Sandra.Walker@unisa.edu.au |
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