International Conference on Pentecostal Theology in the Marketplace

International Conference on Pentecostal Theology
in the Marketplace

Registration Form

* Title

* First Name

* Last Name

* Email address

* Contact Number

* Institution

* Have you applied to present a paper?

Address:

* Street / PO Box

* Suburb/City

State/Territory:

* Post Code:

* Country

Dietary requirements:

* Please tick:

AC Staff

Non AC Staff

* Payment Method

* Credit Card Type

* Name on Card

* Credit Card Number

* Expiration Date (mm/yy)

Direct Deposit:

Once deposited into bank, please ensure you advise our accounts department

Phone +61 2 8893 9000 or Fax +61 2 8893 9099 Email accounts@ac.edu.au

Accounts Name: Alphacrucis College

BSB Number: 062141

Account Number: 28003829

Swift Code: CTBAAU2S

Bank Name: Commonwealth Bank

Branch Name: Chester Hill, NSW

For any questions please email denise.austin@ac.edu.au or check our website for details.

There is a nominal, subsidised fee of $60 which includes all Conference sessions, morning tea and lunch, and the Conference dinner at a local restaurant. Participants will need to cover their own costs of transportation and accommodation. The venue will be AC Central in Parramatta.

* Indicates Response Required