Australasian Nurse Educators Conference 2009
30 September – 2 October 2009
Christchurch Convention Centre, New Zealand


All information should be typed in upper and lower case (eg: Mary Smith).
On completion of the form, click on the "Submit Registration" button at the end of this form.
You have the option of paying either by cheque or credit card (using a secure site)
A Tax Invoice will be sent to the email address you provide, which may be printed.

Personal Information


First Name

Title (Mr/Mrs/Ms/Dr/Prof)



Postal Address


Town/City (or Country if living outside of New Zealand)

Daytime Telephone

Format: NZ = 01 234 5678, International = +_ _ 1 234 5678

Home Telephone

  as above

Mobile Phone

  as above


Please ensure that your email address is correct as your invoice and all correspondence will be sent to this address.

Special Requirements

Dietary: please describe
Mobility: please describe
Other:  please describe
Preferred Name Badge
First Name:    Last Name: 

Privacy Act

The Privacy Act (NZ) 1993 states that, before your name and address details can be published in the list of delegates, either for distribution to fellow delegates or any other party, you must give your consent.

If you do not wish your name, address and details to be included in the list of delegates or provided for use by the conference major sponsors, please tick this box.

Conference Fees
Early Registration
Before1 May 2009.
Payment must be made by 1 May 2009
Standard Registration
1 May to 1 July 2009.
Payment must be made by 1 July 2009
Late Registration
After 1 July 2009.
Conference Registration
Fee includes all refreshments, lunch, and the Conference dinner

Payment Method
Credit Card online
Pay by Cheque
Cancellation must be notified in writing (post/email) to the Organiser.
Cancellations received before Wednesday 2 September 2009 will be refunded less a $50.00 cancellation fee.
No refunds will be issued on or after this date.