W101 Dubbo - Expression of interest

Date:	Monday 1 April 2019
Time:	08:00 – 15:00
Location:	Victoria No.1 Oval, Talbragar Street, Dubbo
Cost:	Members: $380.00 Non Members: $445.00 (includes membership) Morning tea & lunch will be provided.

Company

Booking Contact Name

Street

Suburb

State

Postcode

Select the number of participants

Primary Contact Name

Primary Contact Email

Primary Contact Position

Primary Contact Mobile

Contact is STANSW Member

Yes

No

Dietary Requirements

By completing this form you have nominated the above personnel to attend this event.

When we confirm an appropriate number of participants, we will advise further confirmation details.