EXPRESSION OF INTEREST FORM TO ATTEND FAMILY LEADERSHIP WEEKEND

RSVP Friday 24 June

EVENT DATE: FRI29- SUN 31 July 2016“The Outlook”, Boonah

PERSONAL DETAILS
NAME
ADDRESS
SUBURB / STATE / POSTCODE
PHONE /  Work / Home
MOBILE
EMAIL


Please tell us a little more about your family member/current role?

Please Note: In order to receive a place and organise support, please return as soon as possible even if number of family members attending is unknown. In terms of assistance with cost of flights, please note that depending on demand, we may only be able to support one person per family group in this way.

Details of attending family members

Family
Name / First Name / Relationship
(of attendees) / Age of children if under 18

Please tick if a family member requires an accessible - Bathroom  Bedroom 

General Comments:

Do any members of your family have other support needs or requirements we should be aware of when planning our event? (Please attach more information is necessary)

Are there activities that your adult family member and/or children particularly like or dislike?

PLEASE NOTE: THERE WILL BE A SMALL COST FOR CHILDREN ATTENDING TO COVER ACCOMMODATION CHARGES (Linen costs etc) AND MEALS. The exact cost will depend on age and number of meals provided.

APPLICATION FOR SUPPORT:

Do you require assistance to attend? Please circle YES NO

If, yes, please outline OVER what assistance (accommodation, transport costs, support costs) you require. if any, you are likely to require in order to attend the event If not required please note N/A here
Please be as specific as possible, for example, noting preferred flight times and estimated costs current on day of application. Where a number of flight times may be suitable, please list these. You should consult an online booking site such as Webjet for comparison fares. You should also indicate any specific requirements (dietary, disability, seat preference, if baggage is or isn’t required etc).
DATES OF ANY ADDITIONAL ACCOMMODATION:
INCOMING OR DEPARTING FLIGHT: Date of departure/ City of departure/time of departure/ name of airline and flight number/ cost of fare and/or fare type e.g. “saver fare”
OUTGOING OR RETURN FLIGHT: Date of departure/ City of departure/time of departure/ name of airline and flight number/ cost of fare and/or fare type e.g. “saver fare”
Other travel costs e.g. petrol
Support costs (please note an estimate of hours and breakdown is required including rates of pay and who will provide the support). / Estimated total support costs:
Estimate of hours required / Rate of pay / Who will provide the support
Any other support that would enable you to attend:

CRU’S BUDGET IS LIMITED, but please do not let financial considerations stop you from applying.

Accommodation (Fri/Sat) and Meals are provided as part of the registration fee. Some assistance with transport costs will also be available for regional participants. You are advised not to book flights until you have spoken with us, but please do identify probable needs so we can negotiate what we can offer. Registration forms will be sent after we receive your expression of interest form. For more information call Lisa Bridle on 3844 2211 or

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