GAMSAT Registration Form

Please register for the GAMSAT at www.gamsat.acer.edu.au to obtain your 2010 GAMSAT registration receipt. This registration receipt is required to complete the below registration form.


First Name
Surname
Gender Male Female
Postal Address
Suburb
State
Post Code
Contact Phone Number
Email Address
Status: Currently Studying
Graduated
University
Course/Program
Year Level
Please attach a copy of your 2010 GAMSAT registration receipt
Have you previously sat the GAMSAT? Yes No
Are you an Australian Citizen or Permanent Resident? Yes No
Do you come from a rural background? Yes No
If so, where?
Dietary Requirements
I consent for Rural Doctors Workforce Agency to use or reproduce any photographic images taken as part of educational activities &/or events in publications or other media material produced, used or contracted by the Rural Doctors Workforce Agency including but not limited to: newsletters, flyers, brochures, newspapers, magazines and websites, online groups and forums. Yes No