Please use the form below to register for events organised by Western NSW Primary Health Network

All fields marked with an asterisk (*) are required.

If the event you wish to register for is not in menu below, please register by downloading the flyer from the event page.  

View All Upcoming Events

Please select the event you wish to register for: (required)

Name*:

Email*:

Organisation*:

Profession*:

Phone Contact*:

Receive SMS Reminder?:

SMS Mobile Number:

Dietary Requirements:

Add a guest? (up to 5 guests):

Guest One

Guest 1 Name:

Guest 1 Email:

Guest 1 Organisation:

Guest 1 Profession:

Guest 1 Phone:

Receive SMS Reminder?:

Guest 1 SMS Mobile Number:

Guest 1 Dietry Requirements:

Add a second guest? (up to 5 guests):

Guest Two

Guest 2 Name:

Guest 2 Email:

Guest 2 Organisation:

Guest 2 Profession:

Guest 2 Phone:

Receive SMS Reminder?:

Guest 2 SMS Mobile Number:

Guest 2 Dietry Requirements:

Add a third guest? (up to 5 guests):

Guest Three

Guest 3 Name:

Guest 3 Email:

Guest 3 Organisation:

Guest 3 Profession:

Guest 3 Phone:

Receive SMS Reminder?:

Guest 3 SMS Mobile Number:

Guest 3 Dietry Requirements:

Add a fourth guest? (up to 5 guests):

Guest Four

Guest 4 Name:

Guest 4 Email:

Guest 4 Organisation:

Guest 4 Profession:

Guest 4 Phone:

Receive SMS Reminder?:

Guest 4 SMS Mobile Number:

Guest 4 Dietry Requirements:

Add a fifth guest? (up to 5 guests):

Guest Five

Guest 5 Name:

Guest 5 Email:

Guest 5 Organisation:

Guest 5 Profession:

Guest 5 Phone:

Receive SMS Reminder?:

Guest 5 SMS Mobile Number:

Guest 5 Dietry Requirements:

Please enter the code you see below into the text box.

This is a captcha-picture. It is used to prevent mass-access by robots. (see: www.captcha.net)


Note! Please double-check that all of your details are correct before submitting.