8 - 10 Junie 2009 - Kerkweb.org

kerkweb.org

8 - 10 Junie 2009 - Kerkweb.org

REGISTRASIEVORM / REGISTRATION FORM

Please print this form and fax it to us at 012 420 2000 or email it to suki.vanjaarsveld@up.ac.za or

send it to us at

Centre for Contextual Ministry, Faculty of Theology, University of Pretoria, Pretoria, 0002, SOUTH

AFRICA

Van/Surname:...................................

Voorletters/Initials:............Naam/Name:..........................................................................................

Titel/Title:................

ID: ..................................................................

Adres/Address:..........................................................................................................................

.........................................................................................................Kode/Code......................

Tel:.............................................Selfoon/Cell:...................................................

E-pos/E-mail:................................................................

Ek is ‘n voltydse pastor/leraar/ I am a full-time pastor :

I am a part-time pastor/ Ek is ‘n deeltydse pastor/leraar:

Ek is nie ‘n leraar nie/I am not a pastor:

Denominasie/ Denomination:....................................................................

Plaaslike gemeente/Local church:.............................................................

Tipe gemeente/ Type of church: ...............................................................

Platteland/Rural: Voorstedelik/Suburban: Stad/Urban:

Betaling/Payment: Kontant/Cash: Tjek/Cheque:

(R350)

Bedrag ingesluit/Amount included:.............................vir die volgende kursus/for the following course:

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

Signature/ Handtekening:............................................. Date/Datum:......................................

BANKING DETAILS:

BANK: ABSA

BRANCH: Hatfield

ACCOUNT NO: 407 026 8244

BRANCH CODE: 33-55-45

ACCOUNT TYPE: Current

Please state your surname, initials and telephone number with your electronic

deposit or on the faxed deposit slip

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