Coconnect 2026 Registration Form
WINTEC Hamilton City Campus
Registree Information
Name
*
First Name
Last Name
Phone Number
Optional
Format: (+64) 00000-00000.
Email
*
example@example.com
Are you happy for us to add your email to our mailing database?
*
Yes
No
Ethnicity
*
Profession
*
Company Name / Organization
Optional
Job title
Optional
Event Attendance
Will you be joining online?
Yes
No
Which sessions will you be attending?
Friday 2nd October - Full Day
Saturday 3rd October - Half Day
How did you learn about this event?
Facebook
X
Instagram
Search Engine
LinkedIn
Referral
Word of mouth
Other
Koha/Donations
PPA wants to make the Coconnect Event as accessible as possible and we do not want cost to be a barrier. The full cost of organizing and running our Coconnect event is approximately $450 per person. If you are in a position to help, please consider donating to support event costs and help physiotherapy students and professionals from the region attend.
Koha Donation
$20
$50
$100
$150
$450
Other
Dietary Requirements
Do you have any dietary requirements? If so, please specify below
Please verify that you are human
*
Submit
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