A Passion for Jesus - Online Registration

A Passion for Jesus, Inc is a non profit ministry with a mission to point girls to Jesus Christ!

A Passion for Jesus
ph: 0435 176 863
(+61 435 176 863 from outside Australia)

alt: 813 453 8200 (USA)
info@apassionforjesus.com

Home
Speakers
Upcoming Events
Topics
Testimonies
Registration
Contact Us

Online Registration

Download registration form here or register online. Please complete one form per person attending. Confirmation will be sent via email after your registration has been processed.

First Name:

Last Name:

Email:

Home Phone:

Mobile Phone:

Mailing Address:

Date of Birth:

Additional Information:

______________________________________

I am registering for:

Auckland (Jan 3-6) Melbourne (Jan 17-21) Perth (Jan 24-28) Cootamundra Retreat (Jan 30-Feb 3) Cootamundra One-Day Conference (Feb 4)

If you find you have clicked on the wrong button, refresh the page and try again. :-)

Select Payment Amount:

$195 (Registrations after December 13)

Other Cootamundra Registration Options:

$20 Saturday Conference Only (Registrations after December 13) $200 Retreat & Saturday Conference (Registrations after December 13)

Would you like an APJ T-shirt? ($10 each)

Yes No

Select Payment Type:

*Internet Banking - Direct Deposit Cash ^Cheque/Money Order (not available for NZ)

*If registering in Australia, please make deposits to the following:
Account name: Rachel Coombe
BSB: 033-091
Account: 107014

If registering in NZ, please make deposits to the following:
Account name: Amelia Carson
Bank: ASB
Account: 12 3217 0026811-00

Submit Your Message:

A Passion for Jesus, Inc is a non profit ministry

with a mission to point girls to Jesus Christ!

WWW.APASSIONFORJESUS.COM

A Passion for Jesus
ph: 0435 176 863
(+61 435 176 863 from outside Australia)

alt: 813 453 8200 (USA)
info@apassionforjesus.com