Create Event Personnel

Personal Details

First Name: *

Last Name: *

Organisation:

Position in Organisation:

Date of Birth:

Day:

Month:

Year:

Photo:

Please upload a photo for use in the selection process and online promotion.

Phone Contacts

Mobile Phone: *

Home Phone:

Fax:

Internet Contacts

Email: *

Skype Username:

Facebook Link:

Website:

Address

Address: *

Suburb/City: *

State: *

Postcode: *

Country (if not Australia):

Emergency Contact Details

Please enter here the details for someone we can contact in an emergency. Choose someone who will contactable by phone at the time of the event, but is not likely to be at the event.

Emergency Phone Number: *

Emergency Contact First Name: *

Emergency Contact Last Name: *

Emergency Contact Relationship: *

Medical Conditions:

Please list any medical conditions you have that should be known by the event organisers

About You & Your Services

Description of your services - what do you want to do at this event?: *

Please enter a description of the services you are offering for this event - this will be used in the selection process.

Documents:		Order
	Upload \| Remote URL Maximum file size: 5 MB Allowed extensions: txt pdf rtf doc docx xls xlsx zip rar jpg tif gif bmp Maximum file size: 5 MB Allowed extensions: txt pdf rtf doc docx xls xlsx zip rar jpg tif gif bmp

Please upload any relevant documents for your application - gear lists, quotes, certifications/licences, insurance policies etc

Where are you / your organisation based?: *

Please list the days you are available to work at the event: *

Select which of the days of the event you are available to work at the event

Please indicate here if you have prior commitments over the time of the festival which may impact on your availability:

Financial Info

Requested Payment for Service(s): * $

GST: *

Please outline whether your fee request is inclusive of GST.

ABN:

Admin Fields

Event Edition: *