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C
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PROGRAMME WORKSHOP FEES (INCL GST) PAYMENT Cheques 09.15 -­‐ 10.00 10.00 -­‐ 11.15 11.15 -­‐ 12.15 12.15 – 13.15 13.15 -­‐ 14.15 14.45 -­‐ 15.30 Registration Conference Opening Dr David Hawes “Callous-­‐Unemotional Traits and the Treatment of Conduct Problems in Children and Adolescents” Ms Keryl Egan “Silence! Psychopath at Work” Lunch (provided) Dr Lil Vrklevski “Let’s talk about psychopathy: working with psychopathic features in adults” Conference Closing Annual General Meeting (AGM) for ACPA Members Members Student Members Non-­‐Members Non-­‐Member Students Payable to: 'The Australian Clinical Psychology Association' Send cheques with registration form to: ACPA, c/o 12 The Avenue, Hurstville, NSW 2220 Direct Deposit $155.00 $55.00 $175.00 $75.00 NAB Account 'The Australian Clinical Psychology Association' BSB: 082057 Account number: 172178761 Reference: NOV2014 (include First initial plus surname) Fax registration form to (02) 9579 2460 VENUE ENQUIRIES The University of Sydney, NSW Building A28, School of Physics, Physics Lecture Theatre 2, Rm 424 http://sydney.edu.au/arts/about/maps.shtml?locationID=A28 Transport: http://sydney.edu.au/visitors_community/getting_here/public_transport.shtml Parking: http://sydney.edu.au/visitors_community/getting_here/parking.shtml Please direct ALL enquiries related to this event to [email protected] Confirmation of registration will be sent by email once payment has been processed. CONTINUING PROFESSIONAL DEVELOPMENT (CPD) The day comprises 3 hours of Professional Development (PD). Members of other disciplines or professions attending the conference may be able to claim the conference as CPD provided their governing body does not require event accreditation for PD hours. TERMS & CONDITIONS Registration confirmation: Registrations are confirmed when payment is received and processed. Confirmation of registration will be sent by email to the address provided on the registration form. Receipts will be provided by email. Cancellation Policy: Refunds less a $30.00 administration fee are given for cancellations received in writing via email, mail or fax to The Australian Clinical Psychology Association. Cancellations must be received by 5pm EST Friday 14 November 2014. Regrettably, due to the logistics of event management, refunds are not possible after this date, regardless of personal circumstances or difficulties preventing attendance. The cancellation policy is final and not negotiable. Should the event be cancelled, a full refund will be issued. Transfer of registration: Registrations are transferable to another person in all cases. However, notification of transfer of registration including any dietary requirements must be received by 5pm E ST Friday 14 November 2014. Transfer of registration to another person is NOT possible after this date or for only a portion of the event. C
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REGISTRATION FORM / TAX INVOICE ACPA Conference & AGM, 21 November 2014 REGISTRATION CLOSES: 5pm EST Friday 14 November 2014 REGISTRATION DETAILS Name: _________________________________________________________________________________ PLEASE PRINT NAME AND SURNAME CLEARLY FOR RECEIPTING PURPOSES Profession: __________________________________________ ACPA membership no.: _______________ Email address: __________________________________________________________________________ PLEASE PRINT CLEARLY. CONFIRMATION AND A LL NOTIFICATIONS WILL BE SENT BY EMAIL. Address: _______________________________________________________________________________ State: ________ Postcode: ___________ Contact Tel: ___________________________________________ PLEASE COMPLETE IN CASE OF DIFFICULTY WITH EMAIL Dietary requirements: ____________________________________________________________________ ACCEPTANCE OF TERMS AND CONDITIONS By submitting this registration form I declare that I have read, understood and accepted the Terms and Conditions of registration. FEES (Please tick) ACPA ACPA Student Non-­‐
Student Non-­‐
Member Member Member Member Prices include GST ❐
$ 155
❐
❐
$55
$175
❐
$75
PAYMENT METHOD (Please Tick) ❐ CHEQUE ❐
Payable to: 'The Australian Clinical Psychology Association' Send with registration form to: ACPA, c/o 12 The Avenue, Hurstville, NSW 2220 DIRECT DEPOSIT/BANK TRANSFER NAB Account 'The Australian Clinical Psychology Association' BSB: 082057 Account number: 172178761 Reference: NOV2014 (include First initial plus surname) Fax registration form to (02) 9579 2460
The Australian Clinical Psychology Association
ABN: 90 142 080 617
www.acpa.org.au