Intensive Registration Form

Partner 1 Details

Please provide as much information as possible on this form
Name

First Name Last Name
E-mail *
Mobile
Best contact number
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Partner #1 - Select your spiritual belief *

Standard Non Faith-Specific Catholic Protestant or Non-Denominational Orthodox Christian Jewish Interchurch/Interfaith
Any food allergies to be aware of?
Which do you prefer? Coffee/Tea and how do you like it?
This is so that we know we have it available for you during the intensives

Partner 2 Details

Please provide as much information as possible on this form
Name

First Name Last Name
E-mail *
example@example.com
Mobile
Best contact number
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Partner #2 - Select your spiritual belief *

Standard Non Faith-Specific Catholic Protestant or Non-Denominational Orthodox Christian Jewish Interchurch/Interfaith
Any food allergies to be aware of?
Which do you prefer? Coffee/Tea and how do you like it?
This is so that we know we have it available for you during the intensives

Payment
prev next ( X )
Intensive Workshop ( $ 500.00 AUD for the first month then, $ 2,500.00 AUD for each month )

Full Discounted Payment ( $ 5,000.00 AUD one-time payment)
Should be Empty:

Partner 1 Details