APSAD Early Career Researchers(ECR) BREAKFAST REGISTRATION FORM Tuesday 11 November, Adelaide Convention Centre NAME: (Please Print or Type) MOST RECENT DEGREE & YEAR: CURRENT POSITION: Are you an APSAD Member: Yes TELEPHONE: FAX: EMAIL: I am registered/will register to attend the APSAD Conference: Yes Please note: only those registering for the APSAD Conference can attend the ECR network breakfast event. Return Form by Fax or Email: To: Deborah Dmoch Administrative Officer APSAD email: [email protected] fax: +61 02 9252 2209 Please note that places are limited for this exciting event and registration will be granted on a first in first served basis. Registration closes on 1 October or when all spaces have been filled whichever comes first. When your Registration Form has been received we will send through a confirmation email offering you a place at the breakfast or noting that you are on a waitlist. The APSAD ECR Breakfast is a free event, as places are limited if you are unable to attend please let us know as soon as possible Friday 7 November at latest.This will ensure we can reallocate your place in time. ECR Breakfast attendees will have their names published on the APSAD website and conference website. Attendees names will also be listed on the APSAD ECR network group LinkedIn page, tick the box if you do not want your name included in the list of attendees. As the ECR Breakfast is being sponsored by Universities/Research Centres, we will be passing on contact details for attendees to the sponsoring Universities/Research Centres. Please note this is not for marketing or advertising. Tick this box if you do not want your information passed on.