AICAFMHA:
promoting mental health for young Australians
Australian Infant, Child, Adolescent and Family Mental Health Association Ltd
ABN 87 093 479 022

Pre-registration of contact details - 2004 conference

Pre-registration


AICAFMHA invites you to pre-register your contact details to ensure you receive mail out information about this forthcoming event.

If you are not sure if you are on our mailing list, or have changed address since our last conference and are not an active member, you can submit your details below. Please include your postal and electronic address details.

Items marked * are required fields.

Release of new information about the 2004 Gold Coast conference will be announced via the AICAFMHA News List.

View AICAFMHA's privacy policy.

Name*

Organisation

Address
Street/Postal Suburb
State   Postcode
 
Country if not Australia


Phone Fax Mobile
       

Email*

I am interested in:
    Attending
    Presenting
    Both

I would like information about sponsorship:
    Sponsoring the conference
    Sponsoring an event / part of the conference
    Both

Before submitting your form please read it over to check that you have filled in all the fields correctly. When you are satisfied the form is completed click this box.

  Information accurate

Thank you for completing the above details. The information collected will be added to the conference mailing list.

      


© Copyright AICAFMHA Ltd, 2003

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Last Modified: 23-09-2003 09:53:52