District 70 2008 Annual Conference

Please complete this form in order to submit an individual registration for the 2008 Conference
at Penrith Panthers, charging the cost to a credit card. Note that this is not an e-commerce action.
 Please repeat this registration process for each person attending.

When you submit the form, you will be shown a page confirming your data entry.
This data is not stored on our web server or any other computer. Rather it is sent as a text
email message to District 70, where it is printed and processed along with registrations
received by post or fax. If you wish, you can avoid having your full credit card number appear in
the email message sent to us from the form by following the procedure explained at the bottom
of this form. Should you need to correct any details, please send us a follow up email.

Please provide the following personal details:

First Name
Last Name
Award
Street Address
Address (cont.)
City or suburb
Postcode
Phone Home Work Mobile (select one)
Email
Club (one only)

        Is this your first Conference?    Yes    No

Club Office Current office only
District Office Current office only

        Do you have any special dietary needs or other special requirements?

Needs:

Registration details
Please check appropriate boxes to select functions to attend.

FUNCTION
General Registration $20
This fee permits attendance at all Education Sessions and includes continuous refreshments plus a Conference kit.
Thursday Fun Night $10
Friday Morning Tea $12
Friday River Cruise $17
Friday Civic Reception - No charge
Friday C & L Dinner $44
Saturday Awards Lunch $37
Saturday Dinner $44
(Includes International Speech Contest)
Sunday Breakfast $26
Evaluation Contest $10
Sunday Meet the New Team Lunch $31
(Does NOT include Evaluation Contest)

Please add the cost of options selected and insert cost below.

PAYMENT DETAILS

Credit Card
Cardholder Name
Card Number Please leave spaces between each group of 4 numbers.
Expiration Date
Amount to be charged
   

Note: If you are concerned about your credit card number appearing in
an email message, then include only the first 8 digits in the box above.
After submitting this form, follow it up by sending an email to
ConfRego@d70toastmasters.org giving your name and the
remaining digits on your card.

                              

 Return to What's On at District 70

Toastmasters International District 70
Revised: 25 March, 2008