Cook Islands Annual Health Conference 2025 Participation Registration Form

Cook Islands Annual Health Conference 2025 Participation Registration Form

Please complete all fields in this form to register your participation. Accurate information will help us plan and coordinate the event effectively. All sections marked with an asterisk (*) are mandatory. We appreciate your participation and look forward to your involvement in the discussions and knowledge-sharing sessions.
Personal Information

Please fill out all the required fields.
Title*

Dr.Prof.Assoc. ProfAsst. ProfMr.Ms.MissOther
Name*

First NameLast Name
Employer/Institution*
Department*
Position (if employed) or programme of study (if student)*
Address*
Street, City, Country
Phone Number*

TelephoneMobile
E-mail Address Work/Personal*
Participation Details

Please complete the following fields.
Are you attending as a:

General attendeeStudentResearcherFaculty StaffSpeaker/PresenterOther
Sub-theme Interest
Conference Registration

Please complete the following fields.
Note:
- This is the main registration form and specific options of the conference can be selected where required. A calculation of the total registration fees will be included here.
- Conference Registration fees of NZD200 covers two day conferences, morning tea, lunch and afternoon tea and conference materials.
- Conference Dinner will be held on Wednesday 1st October 2025 at 7pm. All Dinner Tickets are $75 per person.

Please tick the following days/night you will be attending*

Any food allergies? (please specify)
Total Number of Conference dinner tickets required:*
Payment Details

Payments can be made by credit card or bank transfer (via invoice).
Confirmation
Once your registration has been processed you will be given confirmation by email. The invoice will follow by separate email.
Please ensure that the completed Registration Form(s) is submitted online by Monday 1st September, 2025 CKT. For further inquiries, please email our Health Conference comittee at tmo.healthconference@cookislands.gov.ck
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Conference Registration