TCMA Conference » Registration Form

Registration Form/Tax Invoice

Tertiary Campus Ministry Association (Australia) Inc. ABN 752 395 65800

Instructions

Read hints for filling out this form on the Registration Information page.
Complete all sections by typing your details and making your selections.
Review the information you have entered before you click on the "Submit" button at the bottom of the form.
When you click "Submit", this page will check that required information has been entered and allow you to add or correct information. If no errors are found your registration information will be immediately emailed to the registrar.
A printed copy of this form must accompany cheque payments (select File/Print from your browser window).
Note that this page uses Javascript to function correctly. Also, please avoid using symbols other than letters, numbers, spaces and hyphens where possible.

Note: You currently have Javascript disabled. If you wish to submit this form electronically you will need to enable Javascript in your browser and reload/refresh this page.

Section A – Participant Details

Title:
Family Name:
Given/First name:
Preferred Name:

(for name tag)

Religious affiliation &/or denomination:
Position Title:
Institution:
Campus or Location:
Postal Address:
City/Suburb:
State: Postcode: Country:
Email:
Office Telephone:
Fax Number:
* Home Telephone:
* Mobile Number:
Information Sharing Consent:

I consent to the above information, except my home phone and mobile numbers, being made available to other conference participants as part of an attendee list. (*Home telephone and mobile numbers are for emergency use during the conference.)

Section B – Special Requirements

I require on campus parking space Details: I require disabled access Details: I will share with accompanying non participant (eg spouse) Details: Special dietary requirements (eg vegetarian, Kosher, Halal, etc) Details:

Section C – Registration options

Section D – Payment details

I have paid using internet banking transfer

(indicate "Reference" used)

Details: I will print this form and post it with cheque payment

(indicate Bank, Branch and cheque number)

Details: Payment has been included with another participant registration

(indicate participant's name)

Details:

TCMA National Conference

Registration

Registration Form/Tax Invoice

Section A – Participant Details

Section B – Special Requirements

Section C – Registration options

Section D – Payment details