Registration by email

If you wish to choose this option:

• copy sand paste the text below to the contact form found here>
• then completing each part before hitting the [SUBMIT] button.

Registration by mail

If you wish to choose this option:

• copy and pasting the text below to a word processing document on your computer
• complete the form
• print the form
• post the form to:
  • L2g Conference
    c/- Phillip Day
    519 Lyons Street South
    Ballarat  VIC  3350

I wish to register for Leaders to Go Conference

Preferred first name:

Family Name:

Church / organisation:

Role / position (if any):

Postal address:

State:

Post code:

Country:

Please supply the best phone number/s we are permitted to contact you on during office hours:

Phone (Home) if applicable:

Phone (Work) if applicable:

Phone (Mobile) if applicable:

Email:

Website: (0ptional)

Share details:  YES  /  NO  (delete one)
Are you happy to share your name, organisation. role / position, email and website details with other conference delegates?

Attendance:

I am attending full time / part time …   (delete one)

If you are only able to attend part time, please add a note here describing your arrival and departure dates and times as far as you are able at this stage:

.

.

YOUR CONFERENCE FEE AND CHARGES
Please go to or click on the following website page to determine the amount you are electing to be charged. http://leaderstogo.org.au —> REGO —> FEES AND CHARGES

Regarding fees

• Are you electing to pay early bird, standard , late, part-time conference fees? … please copy and paste the line from the above webpage (or make notes) as to:
• I am electing to be charged for:
  • Fee:
  • $:
  • Notes:

Regarding attendance

• [   ] I’m staying on site  OR  [  ] No accomodation required, I’m staying off site (delete one)
• See note on the above webpage regarding part-time or off-site attendance.

Regarding level of accomodation

Require linen?   YES  /  NO  (delete one)

• If YES, please note or copy and paste that charge here:
• $

Please note: Linen includes: one towel, one pillow case and two flat sheets. You will need to bring this bedding if you do not choose this option – a mattress, comforter (a.k.a. quilt/doona) and pillow is supplied. Rooms are heated.

Upgrade package of 2-share- or no-share room?  …

• If YES, please copy and paste the particular package you require here as well as the charge:
• Package:
• $

SPECIAL DIETARY REQUIREMENTS? …

PAYMENT DETAILS

• Delete the payment options you are not using and complete the payment option you are using.

PLEASE FIND MY PAYMENT DETAILS AS:

Option 1 … delete this section if you do not choose this

[   ] Please issue an invoice by post/email (delete one) for payment

OR

Option 2 … delete this section if you do not choose this

[   ] Please find my cheque/money order for $ [… …] in the mail/enclosed (delete one)

• Make cheques out to: Leaders to Go Conference

OR

Option 3 … delete this section if you do not choose this

[   ] Direct Transfer: Bendigo Bank BSB: 633 000

• Acc #: 124646498  Leaders To Go Conference
• Reference Tag: <your first & last name>
• Transfer Receipt Number:
• Please include a printed receipt with a mailed registration or attach it to an email.

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NOTE TO ORGANISERS:

If you have an additional note to organisers, please add this here:

You will need to:

• Register and pay as normal before the early bird cut-off date. Registering early will naturally reduce your costs.
• Complete the simple online application form below.

Preference will be given, in order, to delegates:

1. who will travel more than 2,000km (one-way) to the conference and are not being sponsored or reimbursed by an organisation/church;
2. whose conference fees are paid entirely by individuals who consider that such a payment would be a struggle for them; (although delegates receiving partial help from a small, struggling church may also be considered in this category);
3. who will travel more than 2,000km (one-way) to the conference and are being sponsored or reimbursed by an organisation/church.

It’s up to each delegate what the rebate would be used for however we have in mind it could be used toward:

• B&B accommodation at the conference centre the night prior to the conference commencing if arriving early is necessary;
• a small financial reimbursement towards travel costs; and/or
• help in affording the conference fee.

Notes:

• The amount of assistance/reimbursement will be determined on a case by case basis and will vary according to the finances L2g has available to disperse. i.e, up to twenty $100 rebates for this conference, each delegate receiving no more than one rebate.
• Each application will be considered on its merit. L2g will reimburse successful applicants within 3 weeks after the conference has concluded.