ENVIRONMENT GROUPS FORUM

Saturday 20 August, 5-9 p.m., Newhaven Hall, Newhaven, Phillip Island

Hosted by Phillip Island Conservation Society (PICS)

Funded by Coast Action/Coastcare, Bass Coast Shire & PICS

REGISTRATION FORM

Name of Organisation:

Contact Details:

Name:

Phone:                                                          Mobile:

Email: 

Postal Address

Number of people attending from your group:

Number of people requiring meal ($5 per head, to be paid on the day):

Special dietary requirements for the meal:

Display:

Will you be providing a display?      Y              N           (Please supply own display stands) 

Do you need a trestle?          Y             N

Approximate Size of Display: 

Please return this form NO LATER THAN Friday 5 August to: cgrayden@waterfront.net.au

For further information contact Christine Grayden, Ph 5956 8501, mobile 0400 900 612, or email as above.