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

* 2. Activity you are applying for:

* 3. Applicant Details:

* 4. Organisational Details:

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

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

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

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

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