TMG Registration Form

Please fill out all the fields if possible. When finished click on the 'Submit' button and you will recieve a confirmation that your registration has been sent.

Select if you will be attending the TMG and/or if you would like to make a donation to help someone else attend. Thank you

Yes, I will be attending

Yes, I would like to donate

Amount to donate:

The following will be your contact details and preferences at the Gathering.

Full Name: *

Preferred Name: *

Postal Address *

Suburb: *

State: *

Postcode: *

DOB

Contact Phone: *

Please indicate the various ways to contact you. If you have an Email please be sure to check that as it helps to keep our costs down. Thank you

Email?

Post?

If you have any special dietary requirements, please indicate that here.

Special Dietary Needs:

If you require transport please indicate that here and be sure to include WHERE and WHEN you require transportation.

Transport required:

If you can assist with transport in getting participants to the gathering, please fill in the details.

Assist with Transport:

If you require billeting before or after the Gathering, please indicate the details below especially which nights you require.

Billeting required:

Please choose a Payment Option in A or B only!

Early Bird - pay by 1/02/12

This year the TMG 2012 team has introduced a 'First Timer's Discount' to encourage new participants. To be eligible a First Timer (a man who has never attended a TMG) is invited to attend by a Sponsor (a man who has attended a TMG previously). As an incentive, both the Sponsor and the First Timer are eligible to receive a $50 discount from their normal fees.

NB. When claiming a Concession a Commonwealth concession card is required.

A - Normal Payment Options (not claiming 'First-Timer' discount)

Choose an options if you are not claiming for the 'First-Timer's Discount.

Payment Options (A) - Use these options if you are not claiming the 'First Timer's Discount' *

$450 Full Fee
$400 Full Fee Early Bird
$370 Concession
$350 Concession Early Bird
I will be claiming First Timer's discount below

B - Discount Payment Options (claiming 'First-Timers' discount)

Choose an option if you are claiming for the 'First-Timer's Discount' You are either sponsoring a 'First-Timer' (someone who has not previously attended a TMG) or are a first-timer being sponsored by a previous participant.

For further information please contact the Gatekeeper. (information at bottom of form)

Payment Options (B) - For those who are eligible to claim for the First Timer's Discount.

$400 Full Fee with discount
$350 Full Fee Early Bird with discount
$320 Concession with discount
$300 Early Bird Concession with discount
N/A

Fill-in the field below with either the sponsor's name or the First Timer's name depending on which one is appropriate:

Sponsor/First-timer Name:

TMG 2012
* The TMG is a drug and alcohl free event
* Participants are expected to be at the event for the whole period
* The Gathering is facilitated by Tasmanian men experienced in Men's work

The Gatherings are completely self-funded and are totally reliant on the registration fees collected. Bursaries (TMG only) are given for special cases where there is genuine financial hardship that would prevent a man from attending the TMG. There is a limited amount of bursaries dependant on the generosity from donations. Bursaries are chosen from among the requests received and are awarded by a committee on a needs basis. In all cases there is an expectation for the recipients to be responsible for a part of the payment. For further information contact the TMG Gatekeeper.

Choose your payment method.
Credit Card facilities are not available.
Our preferred method is by direct debit. Be sure to include your name when filling out the request.

I wish to pay by: Cheque Money Order (mail to below) Direct Debit (bank details below)

Mailing Address	Bank Details
TMG 2012 PO Box 1 ROSNY TAS 7018	Bank: Westpac BSB 037 014 A/Nr: 133006 A/Name: Tasmanian Men's Health & WB Description: (YOUR NAME please!)

Any further comments to assist your registration:

Thank you and we are looking forward in welcoming you at the TMG 2012,

Reese Peek (Gatekeeper) 0435 836 828
Email: tmg2012@tasmen.org.au

In order to protect the site from spam please type the letters and numbers you see underneath on the left into the space provided on the right. When finished click the Submit button and your registration will be forwarded to the Gatekeeper. You will receive confirmation shortly thereafter.

Type in the letters and numbers you see on the left. Do not worry about capitals or lower case.

Sorry, please try again.

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