Title/Salutation

First Name

Last Name

Preferred Name

Position

Company

Department/Mine

Mailing Address

Address (street or PO box) *

City *

State *

Post/zip code *

Country *

Preferred Phone Number

Email Address

In-person attendance

I will be attending this event in-person. For international attendees requiring an invitation letter for visa purposes, please enter the required passport details below. If you are unsure, please email info-acg@uwa.edu.au. For more information regarding Australian visas, please visit Home Affairs

None

Yes

Yes and I require an invitation letter for visa purposes

Passport Details

If you are an international attendee requiring an invitation letter for visa purposes, please enter your full name as stated on your passport, issuing country and date of birth.

In-person Dietary/Special Needs Requirements

Attendees List *

I give permission for my details to be included in the conference and associated event(s) attendees list/s.

Yes

ACG Communication *

Would you like to receive ACG communication?

SSIM 2023 Printed proceedings

Conference papers will be freely accessible at the ACG Online Repository of Conference Proceedings. To purchase a softbound, colour, printed copy, order now by selecting from the menu below.

None

1 x copy (+$220.00)

2 x copies (+$440.00)

3 x copies (+$660.00)

4 x copies (+$880.00)

No book

SSIM 2023 Conference Dinner – Alfresco networking cocktail event

Please indicate if you would like to attend the conference dinner – alfresco networking cocktail event, 15 November 2023, in Perth, Western Australia.

Plus one for dinner – full name and dietary requirements if applicable

Please only complete this section with the name of the second dinner attendee, if you have chosen this option.

Please provide your LinkedIn address

linkedin.com

Terms and Conditions *

I read the ACG’s Terms and Conditions.

Yes

test

None

yes

CAD test

Title/Salutation

First Name

Last Name

Preferred Name

Position

Company

Department/Mine

Mailing Address

Preferred Phone Number

Email Address

In-person attendance

Passport Details

In-person Dietary/Special Needs Requirements

Attendees List *

ACG Communication *

SSIM 2023 Printed proceedings

SSIM 2023 Conference Dinner – Alfresco networking cocktail event

Plus one for dinner – full name and dietary requirements if applicable

Please provide your LinkedIn address

Terms and Conditions *