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1. Your details. (Required.)

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2. Primary Employer NB. If your primary Employer is other than the Public Sector or Community Health, please select 'other' and enter details in the field below.

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3. Please indicate which of the following VAHPA Delegate Training courses you wish to attend?

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4. If you are a regional Delegate, which night(s) will you require accommodation for ... (NB If you are unsure at this stage an estimate is ok - we can confirm later on)

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5. Do you have any dietary requirements or restrictions?

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6. T-Shirts.  Please indicate your preferred t-shirt size for your new Delegate photo

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7. Do you have any questions?

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8. Office Use Only

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