First name

Surname

Company (if applicable)

Phone Number

Email Address

Postal Address

What type of registration do you require?

Full Event - IPIQ Member ($375 per person)
Full Event - Non-Member ($449 per person)
Plumbing Professional Development Day Only - IPIQ Member ($195 per person)
Plumbing Professional Development Day Only - Non-Member ($235 per person)
Legionella Seminar Only - IPIQ Member ($195 per person)
Legionella Seminar Only - Non-Member ($235 per person)

Do you have any Special Dietary Requirements?

Yes
No

If yes, what are your dietary requirements?

Will you be attending the Event Dinner on Thursday 29th August 2019?

Yes
No

Will you be bringing a guest to the Event Dinner on Thursday 29th August 2019? (NOTE: $75 for additional ticket)

Yes
No

If booking an additional ticket for the dinner, what is your partner's name and dietary requirements?

Click here if you do not want your contact information available to other conference attendees and sponsors.

No I do not wish to make my details available

It is typical that the staff will take photos, on the day, that may be used for future marketing. Please let the staff know, on the day, if you do not wish your photo to be taken.