Central Division Conference - Online Registration Form

To register electronically for the Central Division Conference, simply fill in the form below and then make your payment using the following details:

For electronic transfer use the following details:
Bank: Bendigo Bank
BSB: 633 000
Account number: 127 746 113
Please use [your surname or second name] as reference

Alternatively, send your cheque to:
Central Division Conference, 94 William St, Norwood SA 5067

Your Name

First Name

Second Name

Your Postal Details

Street Name and Number

Suburb

Postcode

State

Your Contact Details

Phone

Mobile

Club Name

Some details about yourself

Is this your first time at a Central Division Conference? No Yes

Do you have any special meal requirements? If so plese detail for us:

Attendance and Contribution

Full Day - $50.00

Morning - $25.00

Afternoon - $25.00

Lunch - $25.00

Family Special - $120.00

Your contribution amount
Total