Methodist Conference 2011

Auckland

Conference Registration Form

From - 9:30am Saturday 5 November 2011

Until - 3:00pm Wednesday 9 November 2011

Please fill in the form below and click the
"Preview" Button at the bottom of the page.
Please ensure that you answer ALL questions

PERSONAL DETAILS

1

First (preferred) Name:
Surname:
Title:
If 'Other' please specify:
Gender: Female
Male

2

I am a:
In the role of:
Representing:
Parish / Division Number:
(If unsure please leave blank)

3

Are you an ordained minister of another Church appointed to Union or Co-Op Parishes? Yes
No
If 'Yes' please give your Denomination:
Are you an ordained minister of another Church serving with the Conference? Yes
No
Have you been received into Full Connexion with the Methodist Church of NZ? Yes
No

CONTACT DETAILS and SPECIAL REQUIREMENTS

4

Address:
(Must be filled in)
Suburb:
(If unsure please leave blank)
Town / City:
(Must be filled in)
Postcode:
(Must be filled in)
Home Phone Number:
(Must be filled in)
Work Phone Number:
(If unsure please leave blank)
Cell Phone Number:
(If unsure please leave blank)
Email Address:
(Must be filled in)
Please give a phone number you can be contacted on during the Conference:
(If unsure please leave blank)

5

Do you have any special needs
regarding your diet?
If 'Other' please specify:
Do you have any other special needs?
(e.g. wheelchair access, hearing, etc) 		Yes
No
If 'Yes' please specify:

BUSINESS COMMITTEES

6

In order of priority choose which Business Committee you would prefer to attend.
First Preference:
Second Preference:
Third Preference:

WILL YOU BE ATTENDING ANY OF THE FOLLOWING? (Optional Events)

Number
of Tickets 		Event Name and Venue Date and Time Price Per Person
(excl GST)
Tauiwi / Te Taha Maori Meetings
ASB Showgrounds, Greenlane Road 		Friday 4 November 2011
From 10:00am - 5:30pm 		$40
Wesley Historical Society Dinner
Epsom Methodist Church, cnr Manukau and Pah Roads 		Friday 4 November 2011
From 5:30pm 		$26
Lay Preachers Meeting/Lunch
Epsom Methodist Church, cnr Manukau and Pah Roads 		Sunday 6 November 2011
From 12:15pm 		$0
Evangelical and Liberal Society Dinner
Parenting Place, 300 Great South Road 		Sunday 6 November 2011
From 6:30pm 		$22
Pilgrim Productions - Joseph and the Amazing Technicolour Dreamcoat
Pitt Street Methodist Church, 78 Pitt Street, Newton 		Friday 4 November 2011
8:00pm 		$18

Payment is confirmed on the next page

Would you like to be considered
for billeted accommodation? 		Yes
No

PREVIEW FORM

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