Registration Personal DetailsTitle* Surname* First Name* Email Address* Street Address Suburb Postcode State Country Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Institutional/Professional Affiliation (if applicable) Position AMSN 4 Conference Registration InformationRegistration fees cover entry to all panel and keynote presentations, daytime catering over three days, the evening reception on 26 October and a conference pack. The Day Rate covers entry, a conference pack and catering for one day, as well as entry to the evening reception on 26 October. Registration Type* Standard - new or renewing member Standard - current AMSN member Student/part-time waged/unwaged - new or renewing member Student/part-time waged/unwaged - current AMSN member Standard - new or renewing member registration* Early Bird Registration (up to 3 August) - $340 Late Registration (after 3 August) - $380 Day Pass - $170 Standard - current AMSN member registration* Early Bird Registration (up to 3 August) $300 Late Registration (after 3 August) - $340 Day Pass - $150 Student/part time waged/unwaged - new or renewing member registration* Early Bird Registration (up to 3 August) - $160 Late Registration (after 3 August) - $200 Day Pass - $100 Student/part time waged/unwaged - current AMSN member registration* Early Bird Registration (up to 3 August) - $145 Late Registration (after 3 August) - $185 Day Pass - $80 Would you also like to complete your AMSN membership details now? Yes No Membership InformationTo facilitate the exchange of expertise, members’ current research interests and two representative publications are listed on the AMSN website under the ‘Current Members’ section, along with their name, position and institutional affiliation (if applicable), email address and personal webpage address (if provided). Members will be contacted by email periodically (approximately every 12 months) and invited to submit updated information about their research interests and publications.Current Fields of InterestPlease include up to 5 keywords below, separated by semi-colons Current project synopsisRepresentative publications - Title 1 Representative publications - Title 2 Personal Website PaymentPayment is handled via Paypal. After submitting this form you will be directed to Paypal to pay for your purchase and then be returned to this site.Total $ 0.00 NameThis field is for validation purposes and should be left unchanged. Δ
