Registration Form

Lotsha Ministries

Public Benefit Organisation: PBO No:930016973

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Lotsha Online Registration Form
Title:		Address:
First Names:
Surname:
Date of Birth:
ID Number:		Postal Code:
Home Language:

Cell:		Telephone (w):
Telephone (h):		E-mail:
Occupation:

Payment has been made by:		Banking Details:
	No Charge Workshop Direct Deposit - will fax copy to 0866-130-131 Electronic transfer - proof to follow via email or fax		Account name: Lotsha Ministries Bank: Nedbank (Northgate) 169-805 Account No: 1698-064098

Please select the Conference or Workshop below which you would like to attend

Conferences & Workshops		Dates	Price
	Our Offenders, Our Victims, Our Responsibility For more details of this conference, please click on the Conference name	23rd August, 2008	R80.00 (R60 early bird fee if paid by 31st July 2008)
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