registration details…

Send your completed Registration and full payment to…

Gateway Business Centre
PO Box 25,
Baxter 3911 Australia

Fax international…
+613 5971 5625

A full Information Pack will be sent to all Registrants.

refund policy…

A fee of $100.00 per person will apply to any withdrawal made after 11 February 2005.

registration…

Name

Address

Country

Postcode

Phone (work)

Phone (mobile)

Email

method of payment…

Cheque (made payable to Gateway Family Church)

Mastercard    Visa    Bankcard

Cardholder

Card No

Expiry date _______/_______

Total AUD $

Signature

status…

Church Leader

Church Planter 0-2 years

Church Planter 3-5 years

Pastor

conference costs…

Day Delegate.....$595.00

Residential....... $795.00

Yes, I am registering for RPL
status.......
($50.00 on application)