2023 National Conference Registration - On-Site Non-Member

2023 National Conference

Saturday 9th September

Non-Member On-site Attendance Registration

$55.00 per Attendee

Number of Adults Attending *

Number of Children/Infants attending *

All Attendee Names (First and Last Name) *

State

Email address *

Organisation

Special Requirements - Add any dietary needs or other special requirements here *

Total Purchase

Payment Options - to be completed via the shop after submission.

Please select one of the following options for payment

Payment Options *

Direct Deposit/EFT

PayPal/Credit Card

Please deposit funds into the following account via your online banking or in person at branch:

ACCOUNT NAME: Charcot-Marie-Tooth Association Australia Inc. BSB: 032-069 ACCOUNT NUMBER: 158486 *Please use your last name as the transaction description.

Credit Card payments are processed securely online by PayPal. Please click submit below to send details of your Conference Registration to the National office.

To pay by credit card You will be directed to the shop page after submission, add Conference attendance to cart and proceed to check out. Check cart - add extra if required. Complete your details and proceed to the payment page. Select the Pay with PayPal/Credit Card option, and then proceed to PayPal button. On this Page select the Pay by credit/debit card option and follow the prompts. Ensure the submit payment button is clicked for payment to be processed.

To pay by PayPal - follow steps above, on the screen after clicking Proceed to PayPal on payment Options, - Fill in email. and password to login to your PayPal account, then follow prompts, again ensuring the complete payment button is clicked for payment to process.

You will receive a confirmation email from CMT Australia once your registration and payment have been processed.

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