Study Week 2012 Booking Form

Hi. Welcome to the booking page for Study Week 2012, God willing.

We have reached the maximum capacity that the venue can hold, so all bookings are now going directly onto the waiting list.

If you would still like to book into the waiting list, please complete ALL of the following details with the correct information and make the necessary payment via our secure paypal link. (If you don't have a paypal account, you can follow the directions on the paypal page to pay with either a credit or debit card). You will have the option of paying either a deposit, or the full amount for your registration.

Upon completing the form and making payment you will receive a confirmation email saying you are on our waiting list.

Please contact us immediately if you do not receive a confirmation email of your position on the waiting list.

Personal details

First Name *

Last Name *

Gender *

Date of Birth

Choose your payment type

I have read and agree to fulfill the aims and rules set down for the week so that all participants might gain the most possible from the week.

Contact details

E-mail address *

Home Phone Number

Mobile Phone Number

Street Address *

Suburb *

State *

Postal/Zip code *

Country *

Emergency Contact Details

Please enter contact details for use in case of emergency

Parent/Guardian Name *

Relation to you *

Parent

Legal Guardian

Close Relative

Contact Number *

Alternate Contact Number

Your Medicare Number *

Event specific details

Ecclesia

I am baptised

I am married

If your partner is coming to Study Week 2012 also, please enter their name here

I can help with music by playing the following musical instrument(s)

I can help with reading

I can help with chairing

I can help lead Readings Groups

I can help lead Discussion Groups

I would like to share a room with

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Study Week 2012 Booking Form