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1.Personal details (optional)

Name

Dept/Agency

2.Personal details (con't)

Yes

No

Is this your first time attending the PSA Women's Conference?

Yes

No

Are you Aboriginal or Torres Strait Islander?

Yes

No

Is English your first language?

Yes

No

Do you have a disability?

Yes

No

3.I am a:

Women’s Councillor

Central Councillor

Delegate

Member (but not an elected Delegate or Councillor)

Other (please specify)

4.I heard about the PSA Women's Conference from:

A Women's Councillor

A PSA Staff Member

A PSA Delegate or Central Councillor

Another PSA member

Red Tape

Women at Work

The PSA website

PSA News (email)

Other (please specify)