Workshop registration form

Please complete a separate form for each participant.

Please ensure you complete the fields marked * as they are mandatory.

Your details
Title:*	----- MR MRS MS DR
First name:*
Family name:*
Position:*
Organisation:
Address:
ABN:*
Postcode:
Telephone:*
Fax:
Email:
Workshop Details
Workshop Title:*		Date:
Location:*		Fees payable:
Any special requirements, eg, dietary, access etc:
Your feedback
How did you find out about this training workshop?	----- Word of mouth PS News Ombudsman website Brochure Other (please specify in the text box below)
Other referrals

Payment method:

It is the policy of this office that the fee be paid in advance of the training.

A full refund will be given if you cancel up to 10 working days before the event. If you cannot attend another representative from your workplace is welcome to attend in your place. Please advise name.

We cannot accept payment by credit card. Payment can be made by cheque, bank draft or money order, payable to the Office of the Ombudsman, or NSW Ombudsman's Office.