Registration Form
Title:
First Name:
Surname:
Optional: If you would prefer your traditional name or title to appear on your meeting credentials, please provide:
Address
Street:
City/Town:
State/Province:
Post/Zip Code:
Country:
Contact Details
E-mail:
Telephone:
Fax:
Mobile Phone:
Further Details
Institution/ University/Tribal College:
Indigenous Nation/Clan Affiliation:
Working Groups
Please select the top three (in order of preference) working groups you are seeking to participate in:
1st Preference
Accreditation
Language Revitalisation
Exchange, Publicity and Promotions
Software Tools for Indigenous Knowledge Management
Research and Journal
International Funding
Academic Programmes Indigenous Knowledge
2nd Preference
Accreditation
Language Revitalisation
Exchange, Publicity and Promotions
Software Tools for Indigenous Knowledge Management
Research and Journal
International Funding
Academic Programmes Indigenous Knowledge
3rd Preference
Accreditation
Language Revitalisation
Exchange, Publicity and Promotions
Software Tools for Indigenous Knowledge Management
Research and Journal
International Funding
Academic Programmes Indigenous Knowledge
Payment
The payment process by credit card (VISA or Mastercard) can be done upon the submisison of this registration form
Conference charges
Special Requirements
Do you have any special dietary requirements?
Do you have any specific requirements (ie. Auslan interpreting, wheelchair access, etc)?
I agree for my name, organisation, state/country and e-mail to be published on the list of participants.
Please Print your Registration Form before you
Enquiries
Mr Gary Thomasgary.thomas@latrobe.edu.au
