KRISHNAMURTI SPRINGBROOK GATHERING  9-16 Nov 2011           

REGISTRATION FORM: Required for Insurance purposes as well as normal administrative matters; not least for catering.

Should you wish to attend this event, please complete the details below and mail with your full payment to reach the Treasurer no later than 15 October 2011 at:

Krishnamurti Australia
PO Box 40
Mudgeeraba, Qld 4213 

PAYMENT OPTION ONE: Please make NOT NEGOTIABLE Cheque or Money Order payable to Krishnamurti Australia Inc.

 PAYMENT OPTION TWO: If you wish to pay by Credit Card please supply the following details: 

1. Type of Card;   Visa   or   Master Card
2. Name on Card; ..............................................................
3. Card Number;................................................................
4. Expiry Date; ............................
5. CCV Number (last 3 digits on reverse of card);..........................

 PAYMENT OPTION THREE: Pay by Direct Bank Deposit/Transfer to:

1.      WESTPAC BANK at Robina Town Centre.

2.      Account name: Krishnamurti Australia Inc.

3.      Bank BSB No.: 034 279.

4.      Account No.: 266628

5.      Code: KSG & surname.

Please mail a copy of your Bank payment confirmation with this form. 

FIRST NAME....................................SURNAME...........................................

ADDRESS............................................................................................

..............................................................................................................

TELEPHONE NO. ......................................

MOBILE: .......................................................

EMAIL: .........................................................................

 Free transport will be provided from Air and Rail terminals.

I will be flying with;   Jet Star   Virgin Blue   Tiger Air (circle which) and will arrive at Gold Coast (Coolangatta) Airport at;
 time..................date...................

Or

I will arrive at Robina Rail Terminal at; time.................date.......................

 Please arrive as close as possible to 2PM on 9 Nov 2011.