Information
  Application
 
 

　Workshop Application Form 
Your Full Name: *

Contact Number:
( Leave no space between numbers. Please do not use bracket for regional code)

Tel. * Fax.  
Mob.
Email: *
Mailing Address: *
  
Please specify the dates and the 
course of the workshop you like to do  
(Please click on 'accreditation' icon on the top of the web for course details and cost)  
How to apply for the workshop 
Please print this workshop application form (this page), complete it and send it along with cheque or money order payment  to: 
______________________
Exercise Medicine Australia
240 / 303 Castlereagh Street,  
Sydney   2000
Tel: (02) 9281 8868
_____________________
Your registration for the workshop will be confirmed once the payment is received
__________________________
If you do not have a printer, 
simply fill in this form online, 
then click 'Submit'.
A workshop registration form 
will be sent to you 

I would like to apply for the workshop 
as indicated above 

Yes 　　　　　 No
　　　　　

　　　　　



| Disclaimer | Privacy Policy | Contact EMA |
Copyright © Exercise Medicine Australia 2003