Event Registration

Thank you for your interest in the Arts Dinners Live and Online South West Queensland 2020/2021. You can use this registration form to register to attend the next Dinner online (Mental Health 2021 – Tuesday 19th January 2021). Questions marked with an asterisk (*) are compulsory.

If you have any questions or concerns regarding your registration please email us at bronwyn.d@scenicrim.qld.gov.au.

PERSONAL DETAILS
1 Email (*)

Your email address will be kept private. You will log in to your account using this email address.

2 Name (*)
3 Location (*)

Please specify, as a bare minimum, postcode and country (e.g. 4005 Australia).

4 Mobile number
Your mobile number will be kept private.

For Australian numbers, use the format 04nn nnn nnn. For international numbers, use the format +ccc nnnnnnnnn, where ccc is your country code, and nnnnnnnn is you actual mobile number (digits, dashes and spaces are acceptable). For example, a U.S. number of 415 555 2671, could be input as +1 415 555 2671.
4 Profile Photo

We would love everyone to upload an image for their Arts Front Profile. Organisations might like to use their company logo. If you don’t upload an image, a default avatar will be assigned to you.

5 Profile

Tell us about yourself.

6 Tags
Artforms
Focus
7 I'm Sure You're Not a Bot! (*)