14th GeneMappers Conference 2019 – Student registration Please note that your registration will not be complete until payment is received. If you are a human and are seeing this field, please leave it blank. Fields marked with an * are required Title * Mr Ms Dr A/Prof Prof Other First Name * Last Name * Contact number * Email * Position * Organisation * State * ACT NSW NT QLD SA TAS VIC WA Other Postcode Dietary requirements * No special requirements Vegetarian Vegan Gluten free Allergy specific (you will be sent a detailed form to fill out if ticked) Please indicate whether you are interested in participating in an organized early morning kayak trip with fellow GeneMappers. This will be organized if sufficient interest is registered, and will likely be held from 7.00-8.30am on the morning of 21 November (1 hour self-guided group paddle plus briefing, @~$30pp incl GST) [subject to availability; no prior experience required] * No Yes Are you willing to have any photos or video footage taken at the conference which may be used in future promotional material? * YesNo Confirm that you are not a bot *