Young Maori Leaders Conference 2005   

REGISTRATION FORM - PLEASE  COMPLETE ALL FIELDS & USE BLOCK PRINT

 

Mr/Mrs/ Ms ______________________________________________________

 

Position_________________________________________________________

 

Organisation_____________________________________________________

 

Postal Address____________________________________________________

 

Phone______________________________ Fax_________________________

 

Email___________________________________________________________

 

Sponsoring Organisation___________________________________________

 

Preferred Day ONE Afternoon  Workshop - A,  B,  or C  Please circle ONE

Preferred Day TWO Afternoon Workshop -  E,  F,  or D  Please circle ONE

 

Registration fee: $695 + GST (total payment of $781-88) per person for two full day conference. Fee includes lunches, dinner, refreshments, conference documentation and choice of workshops

 

Early Payment Discount: If you register and pay before 11 April 2005 this will be discounted to $495 + GST ( total payment $556-88)

 

Please send with remittance. Tax Invoice will be receipted and returned to you. Our GST Registration Number is 72 063 732

 

Method of payment: Crossed cheque payable to The F.I.R.S.T Foundation, or

    Please invoice me at the above details, or Purchase Order No.________________

 

Cancellations and Transfers: If you are unable to attend, a replacement is welcome. Documentation and a 50% refund will be given for cancellations received in writing on week before the conference. Full refund less $100 administration fee for cancellations received at least two weeks prior to the conference. The F.I.R.S.T. Foundation reserves the right to make any amendments that they deem to be in the best interest of the conference.

 

Signature________________________  Date ______________________

 

Please Return This Form to

The F.I.R.S.T. Foundation, P.O.Box 1078, Shortland St, Auckland, New Zealand OR

Fax (09) 3676805 or email YMLC2005@firstfound.org