Please provide the following information:

Question Title

* First Name (preferred name for Name Tag)

Question Title

* Last Name

Question Title

* Dietary/Health/Access Requirements
If you click yes, please advise requirement in comment box (eg. Halal). We will do our best to cater for your requirement.

Question Title

* Emergency Contact details*: (Please list - Name, Number & relationship to you)

Privacy Notification
Negotiation Education Australia respects the privacy of all individuals. The information you provide on this form is what the Privacy and Personal Information Act 1988 defines as personal information. We are collecting and storing these details so that we can process your enrolment or enquiry, inform you of future activities or events and improve the service we offer you. The only organisations that may use this information are Negotiation Education Australia and the data service providers we engage from time to time. You may choose not to provide certain details, as is your right, but as a result we may be unable to process your enrolment or enquiry, or complete the process for which we were collecting the information. You are entitled to access and alter your personal details at any time by contacting us by telephone, fax or email. If you do not wish to receive any mail or emails in the future, let us know by emailing admin@negotiationeducation.com.au.

Question Title

* I have read the privacy notification above and I consent to my contact details being included in the program participant directory.

T