First Name:
Second Name:
Male/Female:
Hospital or Practice Name:
Postal Address:
Phone  
Home:
Work:
Mobile:
Email:
   
Special dietary requirements for conference and dinner
Other special requirements e.g. disability
Consent to publish name in programme in list of conference delegates
   
CONFERENCE VENUE  

The museum of New Zealand Te Papa Tongarewa (Te Papa)

Taxis and shuttles available from airport to venue www.supershuttle.co.nz to pre book.

   
REGISTRATION PRICE (please indicate)  
Earlybird before 20 May 2019:
21 May to 17 July 2019:
   
Conference presenters: NZ$100 reduction in registration price (please indicate)
   

Late registrations IF ACCEPTED after 17 July 2019:NZ$525
Registration includes two day conference programme, arrival tea and coffee, morning tea, afternoon tea and lunch both days, conference bag, welcome breakfast and the Ego conference dinner.

   
PAYMENT DETAILS (please indicate next to option)
Direct credit NZ Nurses Dermatology Society Inc (NZDNS) BNZ 02 0800 0818185 000 (Reference – please include First and Surname on transfer)
 Invoice made out to :
   
Receipt of payment will be returned by email
INTERNATIONAL DELEGATES:  

Please note that the registration fee must cover the cost of bank charges for the receiving New Zealand bank account which will be an additional NZ$25 to your registration fee. Swift code for international payments is: BKNZNZ22

REGISTRATION IS NOT CONFIRMED UNTIL REGISTRATION FORM & PAYMENT IS RECEIVED BY
Carly Scapens (NZDNS Treasurer) 027 523 8275

Email : carlyscapens@gmail.com 

CANCELLATION POLICY  

Cancellations must be made in writing to Carly Scapens at the above address BEFORE 17 July 2019. Cancellations will incur a $50 administration fee deducted from the refund. No refunds after 17 July 2019.

   
REGISTRATION DETAILS  

Conference registration opens 7.15am Thursday 22nd August accompanied by Welcome breakfast by Pfizer, tea or coffee. Conference commences promptly at 8.30am

   
EGO CONFERENCE DINNER  

Thursday 22nd August 2019, Hummingbird Eatery & Bar 22 Courtenay Place Te Aro Wellington
Number restrictions may apply, so may need to be allocated on a first-in basis. Please indicate if you would like to attend as we need the numbers for catering/reservation purposes. 

   
I would like to attend the Ego dinner on Thursday night
   
ACCOMMODATION  

Conference delegates to arrange their own accommodation.

We have secured a discounted rate at The West Plaza Hotel - USE NZ Dermatology Nurses of NZ as the code to get the following rates: $150.00 NZD per night, per room Queen Room or $165.00 NZD per night per room inclusive of 1 full breakfast. Parking is available for $25.00 per night.  WIFI is unlimited.  Reservations need to be booked through reservations@westplaza.co.nz or phone 04 473 440 Ext 249.  Dont forget to use the code Dermatology Nurses of NZ.