Registration to attend Te Ao Maramatanga Disability Nurses Workshop

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* 1. Your First Name

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* 2. Your Last Name

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* 3. Name of organisation

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* 4. What is your role?

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* 5. Contact email address

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* 6. Contact Phone Number

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* 7. Will you be attending in person?

Yes

No

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* 8. Will you attending via zoom link?

Yes

No

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* 9. Please indicate below if you have any special dietary requirements (if attending in person)