Lead Facilitator workshop registration form

ADDRESS *

PROFESSION: *

Farmer Farm consultant Banker Accountant Meat processor B+LNZ Vet
COMPANY YOU WORK FOR: *

COMPANY ADDRESS: *

YOUR E-MAIL ADDRESS: *
example@example.com
CELLPHONE NUMBER: *
PRIOR FACILITATION EXPERIENCE: *
WHY ARE YOU WANTING TO ATTEND THIS WORKSHOP? *
FURTHER COMMENTS:
*

I understand that I/ the company I work for, will be invoiced $500+GST in advance for attendance on this workshop
INVOICE DETAILS (tick one) *

I will be paying to attend the workshop. Please invoice me for the $500+GST My employer will be paying for me to attend the workshop. Please invoice my employer for the $500+GST
IF YOUR EMPLOYER IS PAYING, PLEASE PROVIDE ANY ADDITIONAL DETAILS REQUIRED FOR INVOICING
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