Sleep DownUnder 2024 - Hypersomnolence Australia Delegate Opportunity

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By filling in this form you are expressing an interest in attending the Australasian Sleep Association's Sleep DownUnder conference as a representative of Hypersomnolence Australia. The conference will be held at the Gold Coast Convention and Exhibition Centre from 16-19 October 2024. You will be required to attend every day of the conference including the Gala Dinner that will be held on Saturday 19th October.

First name *

Surname (Last name) *

What year were you born? *

E-mail address *

Phone number *

What is your postcode? *

What best describes your work/study situation? *

Please note "outside the home" is a general term used to describe working at a job other than home duties and that is how it is interpreted here so if you actually work from home for an employer for example, please check the "outside the home" box that is appropriate to you. Also note: "work" means paid work or volunteering

I work full time outside the home

I work part time (or casual) outside the home

I am a full time student

I am a part time student

I do not work outside the home and I am not a full time student however I am the primary carer for my family or other people with special needs

I have no work, study or carer commitments

Other:

If you work (full, part time or casual), what is your occupation? *

If you study, what are you studying? *

Please indicate which response best describes your connection with the Narcolepsy and/or Idiopathic Hypersomnia community *

I have been diagnosed with Idiopathic Hypersomnia

I have been diagnosed with Narcolepsy type 1 (with cataplexy)

I have been diagnosed with Narcolepsy type 2 (without cataplexy)

I am a parent of a minor (under 18yrs) child diagnosed with Idiopathic Hypersomnia

I am a parent of an adult (over 18yrs) child diagnosed with Idiopathic Hypersomnia

I am a family member or partner (other than parent) of someone living with Idiopathic Hypersomnia

I am a carer or friend (other than a parent or other family member) of someone living with Idiopathic Hypersomnia

I am a parent of a minor (under 18yrs) child diagnosed with Narcolepsy

I am a parent of an adult (over 18yrs) child diagnosed with Narcolepsy

I am a family member or partner (other than parent) of someone living with Narcolepsy

I am a carer or friend (other than a parent or other family member) of someone living with Narcolepsy

Do you have a genuine interest in sleep health research and advocacy? *

Yes

Please tell us why you would like to attend Sleep DownUnder 2024 as a representative of Hypersomnolence Australia *

Please share with us any work or advocacy experience you think may be relevant to this opportunity

Thank you for applying to attend Sleep DownUnder 2024 as a representative of Hypersomnolence Australia. If your application is successful you will receive an email by 31st July. We will also make an announcement on our social media.

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