ANZAOMS NZ Branch ASM 2023 Registration Form

ANZAOMS NZ Branch ASM 2023, 4-5 August - Queenstown, NZ

Delegate Registration Form
Title
Name:*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
E-mail*
example@example.com
Phone Number*
Payment
My Products*
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Full Member
$1,350.00NZD



Full Member Virtual Only
$1,150.00NZD



Registrar
$600.00NZD



Registrar Virtual Only
$500.00NZD



Non-Member
$1,650.00NZD



Non-Member Virtual Only
$1,450.00NZD



Retired Member (Before 1 June 2023)
$400.00NZD



Nurse (Before 1 June 2023)
$400.00NZD



Additional Dinner TicketsSaturday 5 August. 1 Dinner ticket is included in the face to face registration rates, any tickets for partners or guests will need to be purchased.
$150.00NZD Quantity



Subtotal

$0.00NZD

Tax

$0.00NZD

Total

$0.00NZD
Dietary Requirements
Should be Empty:

ANZAOMS NZ Branch ASM 2023, 4-5 August - Queenstown, NZ