Copy the text below into a new email, complete it and send it to info@esperanto.org.au with the subject line “Congress 2025 registration”.
Hello, I wish to register for the Australian Esperanto Congress and Summer School in Adelaide, January 2025. Below are my details. PERSONAL DETAILS 1. First name: ___________________ 2. Family name: ___________________ 3. Address: ______________________________________ 4. Telephone number(s) (inc. area code): ___________________ 5. Email address: ___________________ 6. I am a full-time student at: ___________________ (Leave empty if it doesn't apply) 7. Special dietary requirements (if applicable): ___________________ 8. I intend to participate in the following course (delete those that don't apply): Beginners / Intermediate / Advanced 9. My contribution to the program: ______________________________________ (* lecture, short talk, musical performance, etc, if you would like to) 10. I consent to the following details being included in the “Congress booklet” (delete those that don't apply): Name, Address, Phone number, Email address 11. Dates: ___/01/2025 until ___/01/2025 12. Accommodation: (Delete the line that doesn't apply) - I will be staying at St Anne’s College - I will organise my own accommodation 13. Payment: Level (Delete those that doesn't apply): Bronze / Silver / Gold = AUD .00 Registration fee = AUD .00 Donation = AUD .00 Total = AUD .00 14. Method of payment (delete those that don't apply): - Cheque/money order posted to AEA - Credit card via PayPal (on the website) - Direct deposit into the AEA bank account a. Date I transferred funds to AEA bank account (if applicable): ___/___/___ b. Reference I used to transfer funds to AEA bank account (if applicable): ___________________