Global Coalition against Domestic Violence (GCA-DV)






Please complete this form clearly and return to the conference secretary by e-mail at 

By completing this form, you are agreeing to attend 'The 2011 Indigenous Domestic Violence Conference'.

*Dietary Requirements
Vegetarian  Diabetic Diet  Regular Meal  

*REGISTRATION FEES for the National Indigenous Domestic Violence Conference are as follows and are in AUD: (register early to get a discount!)

                         April 30, 2011......$676

LATE REGISTRATION: After May 01, 2011 and before May 9, 2011.....................$726

VERY LATE REGISTRATION: After May 10, 2011 and before May 16, 2011..........$926

OUT OF TIME REGISTRATION: May 17, 2011...................................................$1,026

Payments can be made either by direct bank transfer, credit card or by check. Cheque payments must be made out and forwarded to:


Sclerology Australia

13/1 Waimarie St.

Bargara 4670 QLD

Phone: 0411488418

Please call or email us if you encounter a problem submitting this form.

It must be noted that any questions in relation to the staging of the event, registrations and the agenda should be addressed to or


Registration fees include all day access to the event, available conference papers, daily buffet lunch and refreshments, for registered delegates only. Fees do not include travel costs or accommodation. Each delegate’s registration is only applicable to that particular person and shared delegate participation is not permitted.


Registration fees must be received within 7 days from bookings. Otherwise, bookings will not be considered. Delegates are urged to register as soon as possible as limited seats are available. We are expecting a very high demand for the event so the earlier you register, the earlier you secure your place at this prestigious event.


The Conference Gala Dinner (Formal Attire) $85 AUD. PLEASE NOTE: Conference dinner and the Pre and Post Conference Events are not included in the registration fee.
**Payment By
Direct Bank Transfer
Credit Card

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