First, complete the details as primary contact for all correspondence.

Then register every person attending, including yourself.

Primary Contact Name*

First Name

Last Name

Primary Contact Address*

Street Address City State Post Code Country

Primary Contact Email*

Primary Contact Phone Number*

Attendee 1 Name*

First

Last Name

Email*

Does Attendee 1 have a Corpus Callosum Disorder?*

Yes

How is Attendee 1 attending:*

Residential Package

2 Day Package

1 Day Package (Specify which day)

Attendee 1 is:*

Adult (18+)

Teen (13-17)

Child (3-12)

Attendee 1 funding is (Please select most applicable):*

NDIS self or plan managed

Primary caregiver of a person who has a self or plan managed NDIS plan (18+ only)

Not NDIS supported.

Attendee 1 Date of Birth*

Is Attendee 1 a registered AusDoCC member?*

Yes

Attendee 1 Non Member (Removal of Discount):

AUD

Does Attendee 1 have any dietary requirements (If none required, please write "Nil"):*

Does Attendee 1 have any additional information that you feel AusDoCC need to be aware of (If none required, please write "Nil")?*

Attendee 1 - Adult NDIS Residential Package*

(Fri-Mon) (Includes all day and night activities, materials, 1-3 nights’ accommodation & all meals)

Attendee 1: Adult Self funded Residential package*

(Fri-Mon) (Includes all day and night activities, materials, 1-3 nights’ accommodation & all meals)

Attendee 1: Teen NDIS Funded Residential Package*

(Fri-Mon) (Includes all day and night activities, materials, 1-3 nights’ accommodation & all meals)

Attendee 1: Teen Self Funded Residential Package*

(Fri-Mon) (Includes all day and night activities, materials, 1-3 nights’ accommodation & all meals)

Attendee 1: Child NDIS Funded Residential Package*

(Fri-Mon) (Includes all day and night activities, materials, 1-3 nights’ accommodation & all meals)

Attendee 1: Child Self Funded Residential Package:*

(Fri-Mon) (Includes all day and night activities, materials, 1-3 nights’ accommodation & all meals)

Attendee 1: One Day NDIS Funded Adult package*

Includes all single day activities, materials, lunch & morning/afternoon tea

Attendee 1: One Day Self Funded Adult Package*

Includes all single day activities, materials, lunch & morning/afternoon tea

Attendee 1: One Day NDIS Funded Under 18 Package*

Includes all single day activities, materials, lunch & morning/afternoon tea

Attendee 1: One Day Self Funded Under 18 Package*

Includes all single day activities, materials, lunch & morning/afternoon tea

Attendee 1: 2 Day NDIS Funded Adult Package:*

Includes activities, materials, lunch & morning/afternoon tea for 2 days

Attendee 1: 2 Days Self Funded Adult Package:*

Includes activities, materials, lunch & morning/afternoon tea for 2 days

Attendee 1: 2 Days NDIS Funded Under 18 Package*

Includes activities, materials, lunch & morning/afternoon tea for 2 days

Attendee 1: 2 Days Self Funded Under 18 Package*

Includes activities, materials, lunch & morning/afternoon tea for 2 days

Attendee 1: Is there another person to register?*

Yes

Attendee 2 Name*

First

Last Name

Attendee 2 Email*

Does Attendee 2 have a Corpus Callosum Disorder?*

Yes

How is Attendee 2 attending:*

Residential Package

2 Day Package

1 Day Package (Specify which day)

Attendee 2 is:*

Adult (18+)

Teen (13-17)

Child (3-12)

Attendee 2 funding is (Please select most applicable):*

NDIS self or plan managed

Primary caregiver of a person who has a self or plan managed NDIS plan (18+ only)

Not NDIS supported.

Attendee 2 Date of Birth*

Is Attendee 2 a registered AusDoCC member?

Yes

Attendee 2 Non Member(Removal of Discount):

AUD

Does Attendee 2 have any dietary requirements (If none required, please write "Nil"):*

Does Attendee 2 have any additional information that you feel AusDoCC need to be aware of (If none required, please write "Nil")?*

Attendee 2: Adult NDIS Funded Residential Package*

(Fri-Mon) (Includes all day and night activities, materials, 1-3 nights’ accommodation & all meals)

Attendee 2: Adult Self funded Residential package*

(Fri-Mon) (Includes all day and night activities, materials, 1-3 nights’ accommodation & all meals)

Attendee 2: Teen NDIS Funded Residential Package*

(Fri-Mon) (Includes all day and night activities, materials, 1-3 nights’ accommodation & all meals)

Attendee 2: Teen Self Funded Residential Package*

(Fri-Mon) (Includes all day and night activities, materials, 1-3 nights’ accommodation & all meals)

Attendee 2: Child NDIS Funded Residential Package*

(Fri-Mon) (Includes all day and night activities, materials, 1-3 nights’ accommodation & all meals)

Attendee 2: Child Self Funded Residential Package:*

(Fri-Mon) (Includes all day and night activities, materials, 1-3 nights’ accommodation & all meals)

Attendee 2: One Day NDIS Funded Adult package*

Includes all single day activities, materials, lunch & morning/afternoon tea

Attendee 2: One Day Self Funded Adult Package*

Includes all single day activities, materials, lunch & morning/afternoon tea

Attendee 2: One Day NDIS Funded Under 18 Package*

Includes all single day activities, materials, lunch & morning/afternoon tea

Attendee 2: One Day Self Funded Under 18 Package*

Includes all single day activities, materials, lunch & morning/afternoon tea

Attendee 2: 2 Days NDIS Funded Under 18 Package*

Includes activities, materials, lunch & morning/afternoon tea for 2 days

Attendee 2: 2 Days Self Funded Under 18 Package*

Includes activities, materials, lunch & morning/afternoon tea for 2 days

Attendee 2: 2 Day NDIS Funded Adult Package:*

Includes activities, materials, lunch & morning/afternoon tea for 2 days

Attendee 2: 2 Days Self Funded Adult Package:*

Includes activities, materials, lunch & morning/afternoon tea for 2 days

Attendee 2: Is there another person to register?*

Yes

Attendee 3 Name*

First

Last Name

Attendee 3 Email*

Does Attendee 3 have a Corpus Callosum Disorder?*

Yes

How is Attendee 3 attending:*

Residential Package

2 Day Package

1 Day Package (Specify which day)

Attendee 3 is:*

Adult (18+)

Teen (13-17)

Child (3-12)

Attendee 3 funding is (Please select most applicable):*

NDIS self or plan managed

Primary caregiver of a person who has a self or plan managed NDIS plan (18+ only)

Not NDIS supported.

Attendee 3 Date of Birth*

Is Attendee 3 a registered AusDoCC member?*

Yes

Attendee 3 Non Member(Removal of Discount):

AUD

Does Attendee 3 have any dietary requirements (If none required, please write "Nil"):*

Does Attendee 3 have any additional information that you feel AusDoCC need to be aware of (If none required, please write "Nil")?*

Attendee 3: Adult Self funded Residential package*

(Fri-Mon) (Includes all day and night activities, materials, 1-3 nights’ accommodation & all meals)

Attendee 3: Child NDIS Funded Residential Package*

(Fri-Mon) (Includes all day and night activities, materials, 1-3 nights’ accommodation & all meals)

Attendee 3: Teen Self Funded Residential Package*

(Fri-Mon) (Includes all day and night activities, materials, 1-3 nights’ accommodation & all meals)

Attendee 3: Teen NDIS Funded Residential Package*

(Fri-Mon) (Includes all day and night activities, materials, 1-3 nights’ accommodation & all meals)

Attendee 3: Adult NDIS Funded Residential Package*

(Fri-Mon) (Includes all day and night activities, materials, 1-3 nights’ accommodation & all meals)

Attendee 3: Child Self Funded Residential Package:*

(Fri-Mon) (Includes all day and night activities, materials, 1-3 nights’ accommodation & all meals)

Attendee 3: One Day NDIS Funded Adult package*

Includes all single day activities, materials, lunch & morning/afternoon tea

Attendee 3: One Day NDIS Funded Under 18 Package*

Includes all single day activities, materials, lunch & morning/afternoon tea

Attendee 3: One Day Self Funded Adult Package*

Includes all single day activities, materials, lunch & morning/afternoon tea

Attendee 3: One Day Self Funded Under 18 Package*

Includes all single day activities, materials, lunch & morning/afternoon tea

Attendee 3: 2 Day NDIS Funded Adult Package:*

Includes activities, materials, lunch & morning/afternoon tea for 2 days

Attendee 3: 2 Days NDIS Funded Under 18 Package*

Includes activities, materials, lunch & morning/afternoon tea for 2 days

Attendee 3: 2 Days Self Funded Under 18 Package*

Includes activities, materials, lunch & morning/afternoon tea for 2 days

Attendee 3: 2 Days Self Funded Adult Package:*

Includes activities, materials, lunch & morning/afternoon tea for 2 days

Attendee 3: Is there another person to register?*

Yes

Attendee 4 Name*

First

Last Name

Attendee 4 Email*

Does Attendee 4 have a Corpus Callosum Disorder?*

Yes

How is Attendee 4 attending:*

Residential Package

2 Day Package

1 Day Package (Specify which day)

Attendee 4 is:*

Adult (18+)

Teen (13-17)

Child (3-12)

Attendee 4 funding is (Please select most applicable):*

NDIS self or plan managed

Primary caregiver of a person who has a self or plan managed NDIS plan (18+ only)

Not NDIS supported.

Attendee 4 Date of Birth*

Is Attendee 4 a registered AusDoCC member?

Yes

Attendee 4 Non Member(Removal of Discount):

AUD

Does Attendee 4 have any dietary requirements (If none required, please write "Nil"):*

Does Attendee 4 have any additional information that you feel AusDoCC need to be aware of (If none required, please write "Nil")?*

Attendee 4: Adult NDIS Funded Residential Package*

(Fri-Mon) (Includes all day and night activities, materials, 1-3 nights’ accommodation & all meals)

Attendee 4: Adult Self funded Residential package*

(Fri-Mon) (Includes all day and night activities, materials, 1-3 nights’ accommodation & all meals)

Attendee 4: Child NDIS Funded Residential Package*

(Fri-Mon) (Includes all day and night activities, materials, 1-3 nights’ accommodation & all meals)

Attendee 4: Teen Self Funded Residential Package*

(Fri-Mon) (Includes all day and night activities, materials, 1-3 nights’ accommodation & all meals)

Attendee 4: Teen NDIS Funded Residential Package*

(Fri-Mon) (Includes all day and night activities, materials, 1-3 nights’ accommodation & all meals)

Attendee 4: Child Self Funded Residential Package:*

(Fri-Mon) (Includes all day and night activities, materials, 1-3 nights’ accommodation & all meals)

Attendee 4: One Day NDIS Funded Adult package*

Includes all single day activities, materials, lunch & morning/afternoon tea

Attendee 4: One Day NDIS Funded Under 18 Package*

Includes all single day activities, materials, lunch & morning/afternoon tea

Attendee 4: One Day Self Funded Adult Package*

Includes all single day activities, materials, lunch & morning/afternoon tea

Attendee 4: One Day Self Funded Under 18 Package*

Includes all single day activities, materials, lunch & morning/afternoon tea

Attendee 4: 2 Day NDIS Funded Adult Package:*

Includes activities, materials, lunch & morning/afternoon tea for 2 days

Attendee 4: 2 Days NDIS Funded Under 18 Package*

Includes activities, materials, lunch & morning/afternoon tea for 2 days

Attendee 4: 2 Days Self Funded Under 18 Package*

Includes activities, materials, lunch & morning/afternoon tea for 2 days

Attendee 4: 2 Days Self Funded Adult Package:*

Includes activities, materials, lunch & morning/afternoon tea for 2 days

Attendee 4: Is there another person to register?*

Yes

Attendee 5 Name*

First

Last Name

Attendee 5 Email*

Does Attendee 5 have a Corpus Callosum Disorder?*

Yes

How is Attendee 5 attending:*

Residential Package

2 Day Package

1 Day Package (Specify which day)

Attendee 5 is:*

Adult (18+)

Teen (13-17)

Child (3-12)

Attendee 5 funding is (Please select most applicable):*

NDIS self or plan managed

Primary caregiver of a person who has a self or plan managed NDIS plan (18+ only)

Not NDIS supported.

Attendee 5 Date of Birth*

Is Attendee 5 a registered AusDoCC member?*

Yes

Attendee 5 Non Member(Removal of Discount):

AUD

Does Attendee 5 have any dietary requirements (If none required, please write "Nil"):*

Does Attendee 5 have any additional information that you feel AusDoCC need to be aware of (If none required, please write "Nil")?*

Attendee 5: Adult NDIS Funded Residential Package*

(Fri-Mon) (Includes all day and night activities, materials, 1-3 nights’ accommodation & all meals)

Attendee 5: Adult Self funded Residential package*

(Fri-Mon) (Includes all day and night activities, materials, 1-3 nights’ accommodation & all meals)

Attendee 5: Child NDIS Funded Residential Package*

(Fri-Mon) (Includes all day and night activities, materials, 1-3 nights’ accommodation & all meals)

Attendee 5: Teen Self Funded Residential Package*

(Fri-Mon) (Includes all day and night activities, materials, 1-3 nights’ accommodation & all meals)

Attendee 5: Teen NDIS Funded Residential Package*

(Fri-Mon) (Includes all day and night activities, materials, 1-3 nights’ accommodation & all meals)

Attendee 5: Child Self Funded Residential Package:*

(Fri-Mon) (Includes all day and night activities, materials, 1-3 nights’ accommodation & all meals)

Attendee 5: One Day NDIS Funded Adult package*

Includes all single day activities, materials, lunch & morning/afternoon tea

Attendee 5: One Day NDIS Funded Under 18 Package*

Includes all single day activities, materials, lunch & morning/afternoon tea

Attendee 5: One Day Self Funded Adult Package*

Includes all single day activities, materials, lunch & morning/afternoon tea

Attendee 5: One Day Self Funded Under 18 Package*

Includes all single day activities, materials, lunch & morning/afternoon tea

Attendee 5: 2 Day NDIS Funded Adult Package:*

Includes activities, materials, lunch & morning/afternoon tea for 2 days

Attendee 5: 2 Days NDIS Funded Under 18 Package*

Includes activities, materials, lunch & morning/afternoon tea for 2 days

Attendee 5: 2 Days Self Funded Under 18 Package*

Includes activities, materials, lunch & morning/afternoon tea for 2 days

Attendee 5: 2 Days Self Funded Adult Package:*

Includes activities, materials, lunch & morning/afternoon tea for 2 days

Attendee 5: Is there another person to register?*

Yes

Attendee 6 Name*

First

Last Name

Attendee 6 Email*

Does Attendee 6 have a Corpus Callosum Disorder?*

Yes

How is Attendee 6 attending?*

Residential Package

2 Day Package

1 Day Package (Specify which day)

Attendee 6 is:*

Adult (18+)

Teen (13-17)

Child (3-12)

Attendee 6 funding is (Please select most applicable):*

NDIS self or plan managed

Primary caregiver of a person who has a self or plan managed NDIS plan (18+ only)

Not NDIS supported.

Attendee 6 Date of Birth*

Is Attendee 6 a registered AusDoCC member?*

Yes

Attendee 6 Non Member(Removal of Discount):

AUD

Does Attendee 6 have any dietary requirements (If none required, please write "Nil"):*

Does Attendee 6 have any additional information that you feel AusDoCC need to be aware of (If none required, please write "Nil")?*

Attendee 6: Adult NDIS Funded Residential Package*

(Fri-Mon) (Includes all day and night activities, materials, 1-3 nights’ accommodation & all meals)

Attendee 6: Adult Self funded Residential package:*

(Fri-Mon) (Includes all day and night activities, materials, 1-3 nights’ accommodation & all meals)

Attendee 6: Child NDIS Funded Residential Package:*

(Fri-Mon) (Includes all day and night activities, materials, 1-3 nights’ accommodation & all meals)

Attendee 6: Teen Self Funded Residential Package*

(Fri-Mon) (Includes all day and night activities, materials, 1-3 nights’ accommodation & all meals)

Attendee 6: Teen NDIS Funded Residential Package*

(Fri-Mon) (Includes all day and night activities, materials, 1-3 nights’ accommodation & all meals)

Attendee 6: Child Self Funded Residential Package:*

(Fri-Mon) (Includes all day and night activities, materials, 1-3 nights’ accommodation & all meals)

Attendee 6: One Day NDIS Funded Adult package*

Includes all single day activities, materials, lunch & morning/afternoon tea

Attendee 6: One Day Self Funded Adult Package*

Includes all single day activities, materials, lunch & morning/afternoon tea

Attendee 6: One Day NDIS Funded Under 18 Package*

Includes all single day activities, materials, lunch & morning/afternoon tea

Attendee 6: One Day Self Funded Under 18 Package*

Includes all single day activities, materials, lunch & morning/afternoon tea

Attendee 6: 2 Day NDIS Funded Adult Package:*

Includes activities, materials, lunch & morning/afternoon tea for 2 days

Attendee 6: 2 Days NDIS Funded Under 18 Package*

Includes activities, materials, lunch & morning/afternoon tea for 2 days

Attendee 6: 2 Days Self Funded Under 18 Package*

Includes activities, materials, lunch & morning/afternoon tea for 2 days

Attendee 6: 2 Days Self Funded Adult Package:*

Includes activities, materials, lunch & morning/afternoon tea for 2 days

There were limited opportunities available for a private 20 minute chat with 5 of our key researchers and clinicians throughout the event. Places were strictly limited. These sessions are allocated based on the earliest expressions of interest. Unfortunately, these spots have now been filled.

Please note, there are NO MORE sessions available for:

Dr Rhonda Booth (Psychologist & Researcher)

Dr Natasha Alexander (Relationships & Sexual Psychologist)

Dr Lynn Paul (Clinical Psychologist & Researcher)

Professor Linda Richards (Neuroscientist)

Dr Monica Cooper (Paediatrician)

TOTAL $ :

If you are an adult with a CCD and have a Companion Card and you wish to bring a companion, please tick box below, and we will contact you.

Companion Card

Further assistance may be available for holders of a blue pension card. Please contact info@ausdocc.org.au for information.

Preferred payment is by bank transfer.

BEFORE pressing submit! If you are paying by bank transfer, please pay the amount listed in the TOTAL at the top with the following details and type your bank's transaction receipt number into the box below. When you click submit, it will take you to the PayPal portal. You can ignore this and close it:

BSB: 013-257

ACCT. NO: 378800587

NAME: AUS DOCC INC.

REF: Your Name C23

Bank Transaction Receipt Number:

By clicking Submit, I confirm that I have read the important information and privacy policy and agree to the Connections 2023 Terms & Conditions.

I require a tax invoice for NDIS purposes.

Yes Please

Please add your NDIS number and best line item for your plan (if known) in this box:*

Sorry, Registrations are now closed.

Connections 2023 – Registration Page

Sorry, Registrations are now closed.

Please contact info@ausdocc.org.au for further information.

Looking forward to seeing you at Connections 2023!