SIGN UP! Influence Conference
REGISTRATION FORM
_____________________________________________________________

REGISTRATION PROCEDURE:
Step 1
Download the form below and register with us.

Step 2
Mail your registration with FULL Payment to the following address:

"Influence Conference" - Youth Alive Malaysia
Glad Tidings Assembly of God
6 Jalan Bersatu 13/4
46200 Petaling Jaya
Selangor Malaysia

REGISTRATION DETAILS:
Early Bird Deadline on 1 June 2009 (Monday)

Registration Fees
Early Bird Registration : RM70 per person
After Early Bird Registration : RM80 per person

- Registration must be accompanied with full payment. Fees are non-refundable.
- Only cheques or money orders are accepted for mail-in registrations.
- All outstation cheques or money orders are accepted for mail-in registrations.
- All outstation cheques must include an additional RM0.50
- Cheques or money orders should be made payable to "Assemblies of God of Malaysia"
- Please write "Influence Conference" at the back of your cheque or money order.


INFLUENCE CONFERENCE REGISTRATION FORM
(please click to enlarge)