AMSI BioInfoSummer 2020 - Registration Form

The Australian Mathematical Sciences Institute (AMSI) and The Australian National University (ANU) are hosting the AMSI BioInfoSummer 2020 virtual conference from 30 November to 3 December.

Registration for AMSI BioInfoSummer 2020 requires both submission of this registration form AND online payment of the registration fee via Eventbrite which you will be redirected to when you submit this form.

For information about AMSI BioInfoSummer visit www.bis.amsi.org.au

If you have any technical issues with the form or receive any errors please contact events@amsi.org.au .

Personal Details

Title

First Name

Last Name

please use the same email address for your registration fee payment and/or grant application form (if applicable)

Mobile Number

Address

City

State/Territory

Please specify Other

Postal Code

Country

Australian Residency Status

Please specify Other

We ask this question due to reporting requirements for funding through the Department of Education. Only de identified data is included in our reporting.

Academic Details

Organisation

Please specify Other

School or Department

Status that best applies to your current occupation/education level

Please specify Other

Main Academic Discipline

Please specify Other

Event Details

Do you have any special access requirements that AMSI BioInfoSummer organisers need to be aware of?

If yes, please provide details

How did you hear about AMSI BioInfoSummer 2020?

Have you attended an AMSI event before?

YesNo

Have you attended AMSI BioInfoSummer before?

YesNo

Registration scholarships

Scholarships are available for students from AMSI Member Universities to assist with the cost of registration fees. Aboriginal and Torres Strait Islander and female students are strongly encouraged to apply. To find out more information visit

www.bis.amsi.org.au

Do you intend to apply for an AMSI BioInfoSummer Registration Scholarhip?

YesNo

Participant Diversity Details

Gender

Do you identify as an Aboriginal or Torres Strait Islander?

If applicable, what was the postcode of your place of residence in Australia during the years you attended secondary school?

If you have any suggestions for increasing equality and access across AMSI programs please detail them here:

The Australian Mathematical Sciences Institute and The Australian National University respect the privacy of individuals and acknowledge that the information you provide on the form is personal information as defined by privacy legislation.

The information is being collected for the purpose of processing of registrations.
The intended recipients of the information are the Event Organisers and any service providers as required (for example, accommodation providers).
The information which you provide is confidential and will not be disclosed without your consent unless the disclosure is authorised or required by law.

By selecting the check box below, I agree:

to participate voluntarily in AMSI BioInfoSummer 2020;
to my name, organisation, and email address being included in a participants list for distribution at the event;
to the Australian Mathematical Sciences Institute and/or The Australian National University recording my voice and/or image, at its discretion, during AMSI BioInfoSummer 2020;
to the use, reproduction, and distribution (in full or in part) of any photographs and recordings made of my voice or image for publicity purposes or for educational use; and
to receive the AMSI e-news (unsubscribe option available) and event related correspondence to keep you informed about BioInfoSummer and other upcoming AMSI events.

I have read and agree to the privacy statement and terms above

IMPORTANT: After submitting this form, you will be redirected to the AMSI BioInfoSummer 2020 Eventbrite page to complete payment of your registration fee for this event. Please wait for this to load and do not press the back button.

Your registration will NOT be finalised until you have submitted this form AND paid your registration fee via Eventbrite.

Contact Information