Linkup Event Application Form

 

Form to be sent to: Australia - D. R., New Zealand - A. M.

    * Please only send one form per linkup venue.

General Information
Name of Event: un 60th Linkup 18-09-05
City/community where linkup is to be screened: Kapiti and Wellington Combined
Linkup Date: 18-09-05
Name of the event venue: Kapiti Libary
Address of the event venue: Rimu Rd Paraparaumu

Globecast Access Card Details
Primary Card No
Backup Card No


Receiver model(s) you are using if known:

Attendance
PWK's
Guests
Aspirants
Total
30
4
0
34

Acknowledgement and Contact Details
"We are aware of the policies* (see page 2 of the Satellite Linkup Guide) and understand the Globecast Access cards will only be activated on receipt of a fully completed form"
Name of Linkup Technical Contact
Chris G.
Phone, email & name on First Class
Atten Chris G. 144 Lala street Wellington ph 04-???????
Name of Linkup Technical Back-up
Murray S.
Name of Local Communication Contact
Marion S.
Date of request
05-04-05
On receipt of this filled-out application form, we will provide your centre with two Globecast Access cards (Primary and Backup). The cost will be A$21.50/card + postage. On this occasion we will fill in the 'Card No' fields for you, but you will be able to fill in these next time.