Convention 2012 - Pre-registration

By filling out the following details you are indicating that you, or a group of people, wish to attend the 2012 MEANZ Convention being held in Whangarei, New Zealand between 5th to 9th January 2012

If individuals that may be part of a group wish to receive Convention updates directly, they should fill out this pre-registration themselves and not include themselves here as part of your group.

Names of individuals within your group (spouses, children) are not vital at this stage but will be required at full registration.

Roger Reynolds is the 2012 Convention Convenor.

First Name
Surname
Number of Adults	Please Select 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
Number of Children	Please Select 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
Days expecting to attend	5th 6th 7th 8th 9th
Postal Address
Email Address
Phone Number
Cell Phone Number
Notes