Form Builder

NZPCN membership

First name

Last name

Preferred name

Mobile phone number

Postal address

Full postal address including postcode.

Organisation

I agree to have my name, organisation and contact email published in the conference handbook

I prefer to receive a PDF version of the conference handbook rather than a paper version

Dietary requirements

Dietary requirements (other)

Your message

Do you wish to present at the conference?

Presentation type

I am a student

Spoken presentation details

Spoken presentations are 12 minutes plus 3 minutes for questions.

Session to present in

Presentation title

Authors

Please enter in the format "Name (Organisation)", with each author on a new line.
Example "Veronica Green (Hebe Heaven Nursery)"

Abstract

Maximum: 1500 characters

I consent to have my presentation recorded and shared by NZPCN on YouTube

Poster presentation details

Presentation title

Authors

Please enter in the format "Name (Organisation)", with each author on a new line.
Example "Veronica Green (Hebe Heaven Nursery)"

Abstract

Maximum: 1500 characters

Payment total

Payment method

If you select invoice we will generate an invoice and email it to you.