Please enter a professional email address when registering for this event. All registrations are subject to approval.
Step 1 – Personal information
First Name
Last Name
Job Title
Organisation
Phone Number
Email
Password
Pronouns
Special requirements (i.e. access requirements)
Type of ticket Please select Charity discount ticket Standard ticket 1 Day Ticket
Preferred Date to Attend Please select Day 1 Day 2
Payment Method Please select Paypal
Name of Contact
Company Name
Email Address
Full Company Address
Packages Select Package 1 Day Ticket 0.0
0.0
Payment Section Select Payment Method PayPal 3D Secure (PayPal) Check (Check)
Step 2 – Questions
What is your discipline? Please select Academia Charity Law enforcement Child protection services Legal Medical Mental health VAWG sector Technology sector Financial sector Government Other
Number of employees in your organisation: Please select 1-50 51-250 251-500 501-1,000 1,000 +
How did you hear about the Tech Summit? Please select Refuge Tech Safety newsletter Refuge Tech Safety website Refuge website Social media From my supervisor/manager/director From a colleague Press release Search engine Speaker Sponsor Other
Step 3 - Acknowledgement
By registering for this event, I agree to receive emails from the Refuge regarding this event. Emails include, but are not limited to registration confirmation, modification and cancellations, event schedules, and communications related to continuing education. I certify that all information provided on this registration is true and correct to the best of my knowledge. By registering for this event, you agree you have read our privacy notice and agree to the terms and conditions.
We would love to keep you informed about future events. Please indicate below the communication you wish to receive. Refuge will not share your contact information.
I wish to be contacted by email: Please select Yes, please No, thank you
I wish to sign up to the Refuge Tech Safety newsletter Please select Yes, please No, thank you
