Registration Form

2018 Advancing Academic Development Event

Recognising, sharing, and shaping academic development practice

Wednesday, 7th November 2018

Bond University, Gold Coast

Mr / Ms / Mrs / Dr / Prof / Assoc. Prof / Other (please specify) ______________________

Family name First name

Preferred name for badge

Faculty/academic unit

Institution

Mobile phone contact Email

Special requirements (dietary, medical or other)

Additional requests:

Please return this completed form to academicdevelopment@qut.edu.au by the close of business Wednesday 24th October 2018. If you have any questions please do not hesitate to contact a member of the project team:

Dr Andrea Adam andrea.adam@utas.edu.au or 03 6226 7116Professor Jillian Hamilton jg.hamilton@qut.edu.au or 07 3138 7548 Associate Professor Marina Harvey marina.harvey@unsw.edu.au or 02 9385 3062