FRSA 3rd National Conference   3 Nov 2010 to 5 Nov 2010   Sebel & Citigate Albert Park - Melbourne     Family Relationship Services Australia is pleased to invite you to register here for the FRSA 3rd Annual Conference to be held at the Sebel and Citigate Albert Park from 3-5 November 2010. Earlybird registration closes 17 September 2010. Please note: Personal information collected by the Event Organiser as a result of your registration for the event, will be used and held in accordance with its Privacy Policy, this can be viewed at http://www.lido.com.au/privacy.asp If you do not have a credit card, please contact DKC on 02 8218 2940 to process your registration.   Title:   *First Name:   *Last Name:   Post Nominal’s:   *Position:   *Organisation:   *Postal Address Line 1:   Postal Address Line 2:   *Suburb:   *State:   *Postcode:   *Country:   *Business phone:   Fax:   Mobile:   *Email:   Please confirm email:   Dietary requirements:   Special requirements:   I'm happy for my details to be distributed in the delegate lists supplied to conference participants: Yes No   *I'm happy for my details to be distributed in the delegate lists supplied to conference sponsors: Yes No    There will be a photographer taking general photos during the event are you happy to be photographed: Yes No   Do you identify as Aboriginal and/or Torres Strait Islander: Yes No   Age bracket: Select 18-25 26-35 36-45 46-60 60+   What type of organisation do you work for?: Select NGO Service Provider Federal Government State Government Research Institute NGO Advocacy or Peak Private Other   How many employees work within your organisation?: Select 1-10 11-50 51-100 101-500 500+   Have you attended previous FRSA conferences: Yes No   How did you hear about the FRSA conference:   Please send me information about Sponsorship Opportunities at the FRSA Conference: Yes No   * field is compulsory. Your Registration *Ticket selection : Earlybird Member Full Registration $780.00 Full Registration includes: 2.5 days conferencing, plus ticket to the Welcome Event and the Conference Dinner. Incl. GST & credit card merchant fee. Earlybird Non-member Full Registration $840.00 Full Registration includes: 2.5 days conferencing, plus ticket to the Welcome Event and the Conference Dinner. Incl. GST & credit card merchant fee. Speaker Full Registration $605.00 Full Registration includes: 2.5 days conferencing, plus ticket to the Welcome Event and the Conference Dinner. Incl GST & credit card merchant fee. Earlybird Day Only – Wed 3 Nov $306.00 Day registration includes: 1 day of conference only. Dinner not included. Incl. GST & credit card merchant fee. Earlybird Day Only – Thu 4 Nov $306.00 Day registration includes: 1 day of conference only. Dinner not included. Incl. GST & credit card merchant fee. Earlybird Day Only – Fri 5 Nov $306.00 Day registration includes: ½ day of conference only. Dinner not included. Incl. GST & credit card merchant fee. Dinner Only - Wed 3 Nov $150.00 Incl. GST & Merchant Fee. Afghan Pamir Restaurant ONLY – Thu 4 Nov $70.00 Includes banquet dinner and transfers. Incl GST & credit card merchant fee. Go to Gaol! ONLY – Thu 4 Nov $80.00 Includes dinner, tour and transfers. Incl. GST & Merchant Fee. Walking Tours of Melbourne ONLY – Thu 4 Nov $100.00 Includes dinner, tour and transfers. All prices incl. GST & Merchant Fee.   Supplementary Options : 0 1 2 3 4 5 6 7 8 9 10 Extra Dinner Ticket - Wednesday 3 Nov $150.00 Dinner is included with full registration. Please book extra tickets to the dinner if you have bought a 1 day registration or wish to bring a friend to the dinner. All prices incl. GST & Merchant Fee. 0 1 2 3 4 5 6 7 8 9 10 Afghan Pamir Restaurant – Thu 4 Nov $70.00 Includes banquet dinner and transfers. All prices incl. GST & Merchant Fee. 0 1 2 3 4 5 6 7 8 9 10 Go to Gaol! – Thu 4 Nov $80.00 Includes dinner, tour and transfers. All prices incl. GST & Merchant Fee. 0 1 2 3 4 5 6 7 8 9 10 Walking Tours of Melbourne – Thu 4 Nov $100.00 Includes dinner, tour and transfers. All prices incl. GST & Merchant Fee. * field is compulsory.