Event Calendar

February 2012
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Upcoming Events

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Registration Form

Convergence (Dec 28th 2011 – Jan 3rd 2012)

REGISTRATION FORM:

Please complete and post with your cheque made payable to “CONVERGENCE”
(To bank directly please check instructions on website www.convergence.net.nz “Event Details / Payment Details” page)

Post to:           CONVERGENCE
P.O. BOX 13 329
CHRISTCHURCH 8141

First Name                 Family Name                               Age 0 -18 or Adult       $

_____________          ________________________            _____________          $________

_____________          ________________________            _____________          $________

_____________          ________________________            _____________          $________

_____________          ________________________            _____________          $________

_____________          ________________________            _____________          $________

Abundance Donation   *(see Details page for more info)                                                    $________

Total   $________

Payment Method Direct Online           Cheque             Physical Deposit at Bank      Cash at Gate

Database Details – In order to let you know about Get-togethers in your local area please indicate

your nearest town/city: ____________________________

Phone: ____________________ Cellphone ________________________

Email:             ______________________________________________________

Food Requirements –  meals are vegetarian if you have specific requirements please include them here:


Ticket Enquires:        Phone Ami      (03) 741  1538

Email               tickets@convergence.net.nz