MIF17 Special Delegate Registration Form Partner sign-up form for MIF17 Select Type*PartnerDelegateSpeakerA delegate is somebody completing the mandatory two days of practitioner training and will be listed on the Mindd Practitioner Directory. Please refer to your partnership agreement for training eligibility.Company* First Name* Last Name* Profession* Mobile* Email* Website Additional InformationWill you be applying for CPD points?* Yes No Which CPD organisation? Will you be attending the speakers reception?* Yes No Clinic Address Public practitioner profiles will be generated for attendees completing the mandatory two days of training using the below information.Clinic Street Address* City* State*Australian Capital TerritoryNew South WalesQueenslandSouth AustraliaTasmaniaVictoriaWestern AustraliaNorthern TerritoryPostcode* Contact Number* Clinic Web Address
