Secondary Conference

PERSONAL DETAILS

First Name:		« Required
Surname:		« Required
School/Organisation:		« Required
Email Address (Required for Confirmation):		« Required
Phone:		« Required
Mobile:

FEES

Prices include GST

Please select one of the following:	ACHPER member 1 day - $90 ACHPER member 2 day - $170 Non member 1 day - $140 Non member 2 day - $260 Grad teacher member 1 day - $75 Grad teacher member 2 day - $150 Grad teacher non mem 1 day - $120 Grad teacher non mem 2 day - $220 Student (full time only) 1 day - $50 Student (full time only) 2 day - $80	« Required
Please List any Dietary Requirements:

Please select one of the following:

ACHPER member 1 day - $90

ACHPER member 2 day - $170

Non member 1 day - $140

Non member 2 day - $260

Grad teacher member 1 day - $75

Grad teacher member 2 day - $150

Grad teacher non mem 1 day - $120

Grad teacher non mem 2 day - $220

Student (full time only) 1 day - $50

Student (full time only) 2 day - $80

« Required

Please List any Dietary Requirements:

Sessions Choices

Registration will not be accepted until BOTH 1st and 2nd preferences are not made. Please note sessions are subject to change due to the cancellation of speakers or insufficient session numbers. In the space provided please write your first and second preference for each session. When choosing sessions please take note of which sessions contain a practical component and require sporting attire.

DAY 1 - Monday 3rd December, 2012

(Please indicate both 1st AND 2nd preferences)

Session 1 (1st Pref):	1st Preference 1.1 1st Preference 1.2 1st Preference 1.3 1st Preference 1.4
Session 1 (2nd Pref):	2nd Preference 1.1 2nd Preference 1.2 2nd Preference 1.3 2nd Preference 1.4
Session 2 (1st Pref):	1st Preference 2.1 1st Preference 2.2 1st Preference 2.3 1st Preference 2.4
Session 2 (2nd Pref):	2nd Preference 2.1 2nd Preference 2.2 2nd Preference 2.3 2nd Preference 2.4
Session 3 (1st Pref):	1st Preference 3.1 1st Preference 3.2 1st Preference 3.3 1st Preference 3.4 1st Preference 3.5
Session 3 (2nd Pref):	2nd Preference 3.1 2nd Preference 3.2 2nd Preference 3.3 2nd Preference 3.4 2nd Preference 3.5

DAY 2 - Tuesday 4th December, 2012

(Please indicate both 1st AND 2nd preferences)

Session 4 (1st Pref):	1st Preference 4.1 1st Preference 4.2 1st Preference 4.3 1st Preference 4.4
Session 4 (2nd Pref):	2nd Preference 4.1 2nd Preference 4.2 2nd Preference 4.3 2nd Preference 4.4
Session 5 (1st Pref):	1st Preference 5.1 1st Preference 5.2 1st Preference 5.3 1st Preference 5.4
Session 5 (2nd Pref):	2nd Preference 5.1 2nd Preference 5.2 2nd Preference 5.3 2nd Preference 5.4
Session 6 (1st Pref):	1st Preference 6.1 1st Preference 6.2 1st Preference 6.3 1st Preference 6.4
Session 6 (2nd Pref):	2nd Preference 6.1 2nd Preference 6.2 2nd Preference 6.3 2nd Preference 6.4
Would you like an invoice?	Yes No

Payment can me made by Chq - please make payable to ACHPER (SA), Cash or Credit Card over the phone

Please note: Once you click SUBMIT you will receive confirmation on screen (scroll to top of page), an automatic confirmation email will be sent to your email.