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ONLINE REGISTRATION FORM

Your Name *
Your Name
Spouse’s Name
Spouse’s Name
Unit/ Apartment Number, Street Number, Street Name, Suburb, State & Postcode
Please input numbers only. No spaces or special characters.
Along with the name of your church, please also supply suburb and state
Opportunity for an extended time of fellowship with conference participants over a meal of roast beef and pork with four vegetables. Please indicate Yes/ No if you would like to be a part of this meal and supply your payment details (if necessary) in the field provided below. NOTE: We request that full payment for all your meal participants be completed by 18 May 2018. Since catering numbers need to be confirmed, we will consider your meal request as cancelled in case we do not receive your payment by this date. We thank you for understanding.
Payments for meals, or donations, may be made via direct debit using the following details. Account Name: NCC Conference Account; BSB: 035 225; Account No: 156460
Please let us know if you would like your email address to be included on the conference mailing list. We will keep your information confidential and will not share it with any other organisation.