Joint Regional Roadshow Enrolment Form

Joint Regional Roadshow

If you already have an account, Sign In here

Client details
Your full legal name must be used as it appears on your driver's licence, passport, etc.
If you are logged in, a pre-populated form cannot be used to enrol another person

Title:

Do you have a 'single name' only?

Yes

First name:

Students with only a ‘single name’ must enter their full name in the 'first name' field.

Middle name:

Last name:

Please provide your RA/RR number if you hold a current registration or license with DMIRS.

If this is not applicable, please type NA in the field below.

Example: RA12345, or NA

Date of birth:

Phone:

Email:

Post Code

Please select if you are a member of:

UDIA

Property Council WA

Other

If other please specify

Do you have any specific dietary requirement?

Yes

Tick if it applies:

Do you have any other specific requirement?

Yes

Term and conditions:

I confirm that information provided on this enrolment form is true and correct to the best of my knowledge.

Payment Options

Elective CPD	$50.00
Elective CPD	$50.00

Subtotal: $50.00

Tax: $5.00

Total: $55.00