NZACOM - Registration Form

CONTACT DETAILS

Title: *

Name: *

Street: *

Suburb/City/State: *

Country *

Postcode: *

Phone:

Email: *

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REGISTRATION DETAILS

Note: All prices are given in New Zealand dollars.

NZACOM Registration fees: Congress registration fee ($45 pp)
Student/Unemployed/Retired ($25 pp)
Priests/Religious (free)

Do you need transport from the airport on arrival? YesNo

Will you be attending the Saturday evening dinner (+$24.50)? YesNo

Please indicate any special meal requirements:

Note: Lunch is not provided on either day, but morning and afternoon tea will be provided.

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PAYMENT DETAILS

What type of payment you will send us?

Note: Online payment is not available.

For Cash, Cheque or Money Order, please send payment to NZACOM c/o Divine Mercy Publications, P.O. Box 20266, Bishopdale, Christchurch 8543, New Zealand.

For Credit Card payments, please fax your details to +64 3 359 2087.

For Internet Transfer, the Banking Details are as follows:

Account Name: Divine Mercy Merivale Christchurch

Account Number: 03 1707 0041871 017

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Total amount for NZACOM Registration: $

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