ANZAOMS NZ Branch ASM 2024, 2-3 August - Queenstown, NZ
Delegate Registration Form
Title
Name:
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
E-mail
*
example@example.com
Phone Number
*
Payment
My Products
*
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( X )
Full Member
$
1,340.00
NZD
Full Member Virtual Only
$
1,140.00
NZD
Registrar
$
620.00
NZD
Registrar Virtual Only
$
520.00
NZD
Non-Member
$
1,640.00
NZD
Non-Member Virtual Only
$
1,440.00
NZD
Retired Member
$
340.00
NZD
Nurse
$
450.00
NZD
Additional Dinner Tickets
Saturday 3 August. 1 Dinner ticket is included in the face to face registration rates, any tickets for partners or guests will need to be purchased.
$
150.00
NZD
Quantity
1
2
3
4
5
6
7
8
9
10
Dietary Requirements
*
Please enter Nil or N/A if you have no specific requirements
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