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Contact Information
The information you provide on this registration form will remain the property of Djirra and will not be shared with anyone else.
Name
*
First Name
Last Name
Postal Code
*
What is the best way to contact you?
Phone
Email
Both
Phone
*
Phone
*
Email
*
Verify Email
*
Email
*
Verify Email
*
Your age?
*
select one
15-17
18-24
25-34
35-44
45-54
55-64
65+
Do you give Djirra permission to take photos of you on the day and possibly use and distribute these images in our publications, on our website and facebook page and on other material without payment to you?
*
Yes
No
Your personal information on this form will not be shared with anyone without your permission. Our privacy policy is on our website.
*
Agree
Disagree
Have you attended and SDO Workshop previously?
Yes
No
If Yes, at which location?
Please indicate your t-shirt size:
*
select one
Size 8
Size 10
Size 12
Size 14
Size 16
Size 18
Size 20
Size 22
Size 24
Size 26
Size 28
If your having issues submitting this form online, please contact Sistersdayout@djirra.org.au