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As the father Has sent me,so I send you John 20:21

< < < Registration Form
Please read the whole brochure before completing this Registration Form.

Information given in this form will be used for COMMISSION 2008 purposes. While some of the information may be shared with the various agencies represented in the convention, it will otherwise be kept confidential by FOCUS Kenya.

Fields marked by * must be filled to process this form.

Registration Form
  *Surname:  
  *First Name:  
  Mid Name:  
  *Permanent Address:  
  Post Code:  
  *Current Address
(Upto Dec 2008):		  
  Post Code:  
  Phone (Mobile):  
  Phone (Landline):  
  Email:  
  *Year of Birth:  
  *Gender:
  Male   Female
 
   
 
  *Marital Status:
  Married   Single
  Other
Name of spouse (if married and also attending Commission.
NB: They should fill a separate Registration Form)
Available on request.
 
  Emergency Contact during Your Time at Commission 2008  
  *Surname:  
  *First Name:  
  Mid Name:  
  *Telephone:  
  Email:  
  *Relationship:  
    Children's details (if your children are also attending).
(NB. If both parents are attending the convention,
then give the children’s details in the father’s form only)
 
  *No. of children:  
  *Name and Age of Children
To pay childrens rate:		  
    NB: Children above 12 yrs should fill a separate Registration
Form and pay student’s rate.Available on request.
 
  *Nationality:  
  *Your Primary Status
at Commission:

if other specify below
 
  *Education Qualification
attained or persuing:

if other specify below
 
  *Area of Speciality in studies:

if other specify below
 
  *Year of Anticipated
Actual graduation:		  
  *For students,
state name of Institution:		  
  *Denomination affiliation:

if other specify below
 
  *State whether you will
reside or commute:
 
  *Convention Fee (Ksh/US$): Paid:   Balance:  
  Indicate whether you would like to be
involved in any of the following during the convention:
 
  If you have a physical limitation or disability,
please indicate below (for purposes of room allocation):

if other specify below
 
  Any special requirements?
(e.g. Allergy, diet etc):		  
     
© FOCUS 2008