Registration Form

Thank you for your interest in the Alcohol, Tobacco and other Drugs Council (Tas) Inc. Conference.
The Conference will be held from 7 - 8 May 2014 at the Hotel Grand Chancellor, Hobart.


Before you Register
Before you begin to complete the online form, we encourage you to take the time to get to know the conference program before you register. Information on the conference program and privacy information can be found on the conference website.


Form Navigation
You are about to begin the registration process for the Alcohol, Tobacco and other Drugs Council (Tas) Inc. Conference. This form will take only a few minutes to fill out. Please have your credit card details ready, required for online payment and complete all of the required fields (REQ). At the end of each page simply click 'Continue'. As you complete the details, be sure to read all instructions at the top of each page and use the Tab Key to move from one field to the next field. All information should be typed in upper and lower case (e.g. William Smith).


Privacy Statement
The delegate list is provided to conference delegates, sponsors and exhibitors of the conference. If you do not want your name to appear on the delegate list please click the privacy required box below. To view the privacy statement please refer to the conference website.


Terms and Conditions
Terms and Conditions apply for Conference Registration. Terms and Conditions can be viewed on the conference website.


Enquiries & Contact
Should you need assistance relating to your registration, or if you do not receive an acknowledgement email within 48 hours, please contact emma@leishman-associates.com.au or call 03 6234 7844.

Please ensure that you complete all 'required' fields below. To navigate through the fields please use the TAB key.
You may leave the Billing details if they are the same as your personal details.

Delegate Contact Details  
Please complete all required fields below
Title
First Name
Last Name
Organisation
Address
City
State (ie: QLD, NSW)
Postcode
Country
Work Phone
Mobile Phone
Email Address
Please tick this box if you do not wish your name and organisation to appear on the delegate list
= required field