Application to Attend the 2023 IPTN Conference

Application to Attend the 2023 IPTN Conference

This application will take 20-30 minutes to complete - you are welcome to complete the application in your home language. The application is in English. Translated application questions are available on the IPTN Conference webpage. The following languages are available: Spanish, Italian, Portuguese, Korean, Chinese, Russian and Turkish. Please take note that applications are not accepted on a first-come-first-served basis; the South African steering committee will be offering places that reflect access, equity and representation from the global community.
Personal details:
1. Name*

First NameLast Name
2. Email*
example@example.com
3. Mobile number*
4. What is your preferred pronoun? *
5. What is your nationality? *
6. What is your country of residence? *
7. If you are living with a disability, please share any information that you would like us to know.
8. Are you a member of a PB company/companies at present? If so, please provide details. *
9. Have you previously attended an IPTN conference? If so, please provide details.*
10. Have you been accepted to offer an item on the programme?*

YesNo
11. If you answered 'Yes', please indicate the item/s:

HomegroupPerformancePanelWorkshop
12. Are you currently a member of IPTN?*

YesNo
13. Indicate your dietary preference:*

VegetarianVeganHalaalKosherDiabeticDairy-freeWheat-freePescatarianNone
14. If your dietary restriction is other, please specify:
15. Are you able to volunteer at the conference? If so, please provide details. If you are selected as a Conference Volunteer, you will be eligible for a 50% discount (if you are not already approved for any other scholarship). The conference organising committee will be appointing 20 volunteers from the continent and 5 international volunteers. Volunteering Examples: guest relations, transport logistics, venue support, communications, crowd management, support desk.
Language and Translation:
16. What is your first language?*
17. Which other languages do you speak? *
18. Do you need translation from English into your home language?*

YesNo
19. If you answered ‘Yes’, please provide details.
20. Can you offer translation from English into another language?

YesNo
21. If you answered ‘Yes’, please provide details.
22. Have you provided translation at any previous Playback Theatre events?

YesNo
23. Select the items you have previous experience translating:

Playback Theatre performancesWorkshopsConferencesPanel DiscussionsWritten translation from English into another language
24. Comments and suggestions regarding language and about translation:
Packages and Fees:

The Conference Package is: Early Bird ZAR 4500 ($260/€247). Early Bird rates close on 12 February 2023. Standard Fee ZAR 5000 ($288/€273). Standard Fee will be taken into account for all applications AFTER 12 February. Including: conference attendance and lunches and our opening gala dinner. Excluding: accommodation, flights and personal expenses.
Discounts and Scholarships:
25. Programme contributors, IPTN members, volunteers and translators are eligible for a discounted rate on their conference registration fee. *Homegroup leaders and volunteers will receive a 50% discount; *translators, workshop leaders, panelists and performers will receive a 20% discount; *IPTN members will receive a 10% discount. Each conference attendee is only eligible for one of these discounts. Instead of receiving that discount those people can choose to pay the full fee and donate their discount to the conference scholarship fund. Should you be eligible for a discount but wish instead to pay the full price and make a donation, kindly indicate below.*

This does not apply to me (I am not a programme contributor, IPTN member, volunteer or translator)I need to claim my discountI am eligible for a discount but wish to pay full price in support of the scholarship fund
Donate to the Scholarship fund:
26. Even if you are not eligible for a discount you can still make a contribution towards the scholarship fund. Your generous donation will go towards providing a scholarship to a scholarship applicant.

I am not in a position to donateI would like to donate an amount equivalent to 25% of the standard conference feeI would like to donate an amount equivalent to 50% of the standard conference feeI would like to donate an amount of my choosing
27. If you would like to donate an amount of your choosing (please type in your own amount in US $):
Applying for a scholarship:
28. Are you in need of a scholarship to attend this conference?*

YesNo
Kindly take note of the following: - Scholarships are not the same as discounts. The following people are eligible for discounts: IPTN members, programme contributors, translators and conference volunteers. - If you are eligible for a discount and also successfully apply for a scholarship, your conference fee will reflect only whichever of those amounts is greater i.e. you cannot receive both a discount and a scholarship. - The IPTN together with a group of volunteers from our Playback Community are working at securing either full or partial scholarships for a limited number of conference attendees. It is possible, but unlikely, that no scholarships will be offered. - An independent scholarship committee with backgrounds in community building and training will recommend which scholarship applicants receive support, based on their responses to the application questions below. - The decision of the committee will be final. - By submitting your scholarship application you acknowledge that you understand and accept those conditions.
29. Please tell us in some details why you are in need of a scholarship to attend this conference? (150 words maximum)*

0/150
30. Who is your referee? (please provide a name, email address and phone number for a playback colleague who has agreed to be your referee. The referee should preferably be an experienced practitioner who can be honest about your current participation in playback, your strengths and your playback development needs):*

0/150
31. What is your employment status? (Select any that apply to you)*

Substantially unemployed, retired, or a pensionerPart time employed (including casual, freelance or consultant work)Full time employedFull time studentPart time student
32. If your employment status is anything other than listed above, please provide brief details:
33. Have you previously received a scholarship to attend any IPTN conferences or local Playback Theatre events?*

YesNo
34. Please estimate your total expenses (US $) for flights and visa (if needed), to attend the IPTN Conference (excluding the registration fee)*
35. If you don’t receive a scholarship will you still be able to attend the Conference?*

YesNo
36. How will attending this conference benefit you in your Playback Theatre work? (150 words maximum)

0/150
37. How will the Playback community benefit if you receive a scholarship? (150 words maximum)*

0/150
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Application to Attend the 2023 IPTN Conference

Personal details:

Language and Translation:

Packages and Fees:

Discounts and Scholarships:

Donate to the Scholarship fund:

Applying for a scholarship: