Current Details Conference Dinners Extras Summary Please complete this form to register for the conference. Membership status Are you a member of ICPA? Yes No Attendance type Will you be attending as an individual, school or business? Individual School Business IMPORTANT: Please submit this form separately for EACH person attending the conference. Organisation Position title First name Last name Phone number Email address Branch Membership Details Which branch are you a member of in SA? - Select -Eyre BranchFlinders RangesMarla OodnadattaMarree AirNorth EastNorth WestPort AugustaSA Lone Members State councillor Are you a state councillor? Yes No Federal councillor Are you a Federal councillor? Yes No Additional person Additional Person Will any additional persons under your ICPA membership be attending the conference with you? Yes No Additional first name Additional surname
