Convention Registration

National Convention in Adelaide, 3—6 October 2008

You can use the form below to register (and pay for) the Conference Online... or if you prefer you can download the registration form, print it off, fill it in, and post it to us (along with payment).

Registrations to:

Bill Prior       22 The Dress Circle, ATHELSTONE, 5076
Phone:        08 8336 1629 (H)    0411 721 239 (Mobile)
Email:         billprior@yahoo.com

You will also need to pay on registration by one of the methods outlined below :
(click here for payment instructions)

Registration received after Friday 1 August = $225

Day Rate Options:
Note: to Register and Pay for Day Rates, you cannot use this online form. Please download the registration form, print it off, fill it in, and post it to us (along with payment).

Friday evening—Saturday afternoon = $125
Saturday evening—Sunday afternoon = $125
Gala Convention Dinner only = $75

For more details contact:

Loris Glass, President SA Churchill Fellows Assoc
(08) 8332 7929 AH (08) 8226 8869 W Mob 0422 002 884
Email: glass.loris@saugov.sa.gov.au

Online Registration

Your Details

Title :
First Name :
Surname :

Contact Details

Address :
Email Address :
Phone Number :
Mobile :
Year & Category of Fellowship :

Partners Details

Partners Title :
Partners First Name :
Partners Surname :

Comments

Comments and/or Other Attendee Names

Event Details

This section is intended to provide us with an indication only as to how many people are likely to attend various scheduled events and activities.

For each activity please indicate how many people included with this registration are likely to attend :

Activity	# Persons
On Friday night I will be attending the Civic Reception at the Lyrics Lounge
On Saturday I will be visiting Adelaide Oval, Zoo and the National Wine Centre (morning tea, lunch and afternoon tea provided)e
On Saturday evening I will be attending the Convention Gala Dinner at the Pavilion on the Park, South Terrace, Adelaide
On Sunday morning I will be visiting Liquid Metal Studios and Carrick Hill (morning tea provided).
On Sunday afternoon I will be attending the lunch and farewell reception.
On Monday morning I will be attending Botanic Gardens (breakfast at own cost).
On Monday afternoon I would like to be part of the group to share lunch and a game of golf (at own cost).
I would like to accept the offer of being billeted please.

Please note events may change subject to demand and availability.

Please advise of any special dietary requirements or other special needs.

Full registration (t$225) includes ALL activities on Friday, Saturday and Sunday.

Payment Details

# of attendees :
Intended Payment Method :

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