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* 1. Please indicate the field you are interested in applying under:

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* 2. Activity you are applying for:

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* 3. Applicant Details:

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* 4. Organisational Details:

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* 5. Professional Bio - please give a short description of your professional role and interests:

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* 6. Outline your personal experience and connection with event topics:

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* 7. How will you incorporate your learning from this event into your current and future work?

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* 8. Do you have any specific needs (dietary/access)?

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