Australian Nursing and Midwifery Conference 2021
Thursday 06 May 2021 to Friday 07 May 2021
PIN
(If you have already sent your details to this event)
Please ensure you read the Registration Conditions before registering. One form must be completed for each delegate. If you have previously registered, but wish to update your details, please contact East Coast Conferences. Please note that if you are paying on-line by credit card that the payment will appear on your credit card statement as a transaction with MIE Software Pty Ltd Port Melbourne.
Contact the
event organiser.
Personal Information
Title
First Name
*
Family Name
*
Badge Name
(only if different from above)
Job Title
Division
Organisation
Address Line
1
*
Address Line 2
Suburb/City
*
State
*
Postal Code
*
Country
None
PLEASE SELECT
AFGHANISTAN
ALASKA
ALBANIA
ALGERIA
AMERICAN SAMOA
ANDORRA
ANGOLA
ANGUILLA
ANTARCTICA
ANTIGUA AND BARBUDA
ARGENTINA
ARMENIA
ARUBA
AUSTRALIA
AUSTRIA
AZERBAIJAN
BAHAMAS
BAHRAIN
BANGLADESH
BARBADOS
BELARUS
BELGIUM
BELIZE
BENIN
BERMUDA
BHUTAN
BOLIVIA
BOSNIA AND HERZEGOVINA
BOTSWANA
BOUVET ISLAND
BRAZIL
BRITISH ANTARCTIC TERRITORY
BRITISH INDIAN OCEAN TERRITORY
BRUNEI DARUSSALAM
BULGARIA
BURKINA FASO
BURUNDI
CAMBODIA
CAMEROON
CANADA
CAPE VERDE
CAYMAN ISLANDS
CENTRAL AFRICAN REPUBLIC
CHAD
CHILE
CHINA
CHINA TAIWAN
CHRISTMAS ISLAND
COCOS (KEELING) ISLANDS
COLOMBIA
COMOROS
CONGO
COOK ISLANDS
COSTA RICA
COTE D'IVOIRE (IVORY COAST)
CROATIA (HRVATSKA)
CUBA
CYPRUS
CZECH REPUBLIC
DEMOCRATIC REPUBLIC OF CONGO
DENMARK
DJIBOUTI
DOMINICA
DOMINICAN REPUBLIC
EAST TIMOR
ECUADOR
EGYPT
EL SALVADOR
ENGLAND
EQUATORIAL GUINEA
ERITREA
ESTONIA
ETHIOPIA
FALKLAND ISLANDS (MALVINAS)
FAROE ISLANDS
FIJI
FINLAND
FRANCE
FRENCH AUSTRAL AND ANTARCTIC TERRITORIES
FRENCH GUIANA
FRENCH POLYNESIA
FRENCH SOUTHERN TERRITORIES
GABON
GALAPAGOS
GAMBIA
GEORGIA
GERMANY
GHANA
GIBRALTAR
GREECE
GREENLAND
GRENADA
GUADELOUPE
GUAM
GUATEMALA
GUERNSEY
GUINEA
GUINEA BISSAU
GUYANA
HAITI
HAWAII
HEARD AND MCDONALD ISLANDS
HONDURAS
HONG KONG
HUNGARY
ICELAND
INDIA
INDONESIA
IRAN
IRAQ
IRELAND
ISLE OF MAN
ISRAEL
ITALY
JAMAICA
JAPAN
JERSEY
JORDAN
KAZAKHSTAN
KENYA
KIRIBATI
KOREA (NORTH)
KOREA (SOUTH)
KUWAIT
KYRGYZSTAN
LAOS
LATVIA
LEBANON
LESOTHO
LIBERIA
LIBYA
LIECHTENSTEIN
LITHUANIA
LUXEMBOURG
MACAU
MACEDONIA
MADAGASCAR
MALAWI
MALAYSIA
MALDIVES
MALI
MALTA
MARSHALL ISLANDS
MARTINIQUE
MAURITANIA
MAURITIUS
MAYOTTE
MEXICO
MICRONESIA
MOLDOVA
MONACO
MONGOLIA
MONTSERRAT
MOROCCO
MOZAMBIQUE
MYANMAR
NAMIBIA
NAURU
NEPAL
NETHERLANDS
NETHERLANDS ANTILLES
NEW CALEDONIA
NEW ZEALAND
NICARAGUA
NIGER
NIGERIA
NIUE
NORFOLK ISLAND
NORTHERN IRELAND
NORTHERN MARIANA ISLANDS
NORWAY
OMAN
PAKISTAN
PALAU
PALESTINE
PANAMA
PAPUA NEW GUINEA
PARAGUAY
PERU
PHILIPPINES
PITCAIRN
PLEASE SELECT
POLAND
PORTUGAL
PUERTO RICO
QATAR
REUNION
ROMANIA
ROSS DEPENDENCY
RUSSIAN FEDERATION
RWANDA
S. GEORGIA AND S. SANDWICH ISLS
SAMOA
SAN MARINO
SAO TOME AND PRINCIPE
SAUDI ARABIA
SCOTLAND
SENEGAL
SEYCHELLES
SIERRA LEONE
SINGAPORE
SLOVAK REPUBLIC
SLOVENIA
SOLOMON ISLANDS
SOMALIA
SOUTH AFRICA
SPAIN
SRI LANKA
ST. HELENA
ST. KITTS AND NEVIS
ST. PIERRE AND MIQUELON
ST. VINCENT AND THE GRENADINES
SUDAN
SURINAME
SVALBARD AND JAN MAYEN ISLANDS
SWAZILAND
SWEDEN
SWITZERLAND
SYRIA
TAIWAN
TAJIKISTAN
TANZANIA
THAILAND
TOGO
TOKELAU
TONGA
TRINIDAD AND TOBAGO
TUNISIA
TURKEY
TURKMENISTAN
TURKS AND CAICOS ISLANDS
TUVALU
UGANDA
UKRAINE
UNITED ARAB EMIRATES
UNITED KINGDOM
UNITED STATES OF AMERICA
URUGUAY
US MINOR OUTLYING ISLANDS
UZBEKISTAN
VANUATU
VATICAN
VENEZUELA
VIET NAM
VIRGIN ISLANDS (BRITISH)
VIRGIN ISLANDS (U.S.)
WAKE ISLAND
WALES
WALLIS AND FUTUNA ISLANDS
WESTERN SAHARA
YEMEN
YUGOSLAVIA
ZAIRE
ZAMBIA
ZIMBABWE
Business Phone
*
Mobile Phone
E-Mail Address
*
Confirm E-Mail Address
*
Special Dietary Requirements
Special Needs
Profile Information
Please indicate here if you do not wish to have your details included on the delegate list. The delegate list will be distributed to conference sponsors and exhibitors, and will include name, organization and email address. Please also indicate your clinical area, if applicable.
Do not include details on delegate list
My clinical area is Nursing - Adults
My clinical area is Nursing - Paediatrics
My clinical area is Midwifery