Lions MD 201 Australia & Papua New Guinea “A New …201q2.lions.org.au/files/201q2/FINAL Rego Form...
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Lions MD 201 Australia & Papua New Guinea 66th National Convention Townsville 4-7 May 2018 “A New Century of Service” REGISTRATION FORM Office Use Only Registration closes Friday 20th April ID No. Rec.Date Club Name District Club No. Registrant Details Title Designations : Lion, Lioness, Leo, CC, PCC, DG, PDG, PIP, ID, PID, Lions Partner, Non Lion Title Given name Surname 1st convention Registrant Yes No Partner Yes No Guest Yes No Contact Details Address P/C Email address Phone Emergency contact Emergency Phone No Please indicate any specific dietary OR other needs Travel arrangements & accommodation Conventioneers are responsible for arranging own accommodation Method of travel Car, Bus, Train, Air Flight No.date & time I will be staying at: From To Registrations : Other Correspondence to : The Registrar, Lions MD 2018 Convention, The Secretary, Lions MD 2018 Convention, Box 6380 Mail Centre, Mackay, Qld 4741 PO Box 659, Aitkenvale, Qld 4814 [email protected] [email protected]
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Transcript of Lions MD 201 Australia & Papua New Guinea “A New …201q2.lions.org.au/files/201q2/FINAL Rego Form...
Lions MD 201 Australia & Papua New Guinea66th National Convention Townsville 4-7 May 2018
“A New Century of Service”
REGISTRATION FORM Office Use Only
Registration closes Friday 20th April ID No.
Rec.Date
Club Name District Club No.
Registrant Details
Title Designations : Lion, Lioness, Leo, CC, PCC, DG, PDG, PIP, ID, PID, Lions Partner, Non Lion
Title Given name Surname 1st convention
Registrant Yes No
Partner Yes No
Guest Yes No
Contact Details
Address P/C
Email address Phone
Emergency contact Emergency Phone No
Please indicate any specific dietary OR other needs
Travel arrangements & accommodation
Conventioneers are responsible for arranging own accommodation
Method of travel Car, Bus, Train, Air Flight No.date & time
I will be staying at: From To
Registrations : Other Correspondence to :
The Registrar, Lions MD 2018 Convention, The Secretary, Lions MD 2018 Convention,
Box 6380 Mail Centre, Mackay, Qld 4741 PO Box 659, Aitkenvale, Qld 4814
Lions MD 201 Australia & Papua New Guinea 66th National Convention Townsville 4-7 May 2018
FORM 2
Date Event Schedule Event Notes Cost No.Sub
Totals
Thurs
3rd
MD201 Tree planting activity See detail next page note A Free
Thurs
3rd
Lioness Dinner See detail next page note B 50$
Fri
4thLunch See detail next page note C
Fri
4thInformal Reception See detail next page note D 27$
Fri
4thLeos Night Out See detail next page note E
Fri
4th
PDG's Dinner See detail next page note F
Sat
5th
Key Members & First Conventioneers
BreakfastSee detail next page note G 25$
Sat
5th
Lunch See detail next page note C
Sat
5th
Tropical Gala Ball See detail next page note H 79$
Sun
6th
Lunch See detail next page note C
Sun
6th
District Functions See detail next page note J
Mon
7th
Lunch -Convention lunch - BBQ by Lions See detail next page note K 15$
Mon
7th
Past & Present Cab Secs, Cab Treas, &
current D.G.'s & Partners lunchSee detail next page note L 35$
Mon
7th
Council Chair, Intern. Director, PIP, PID's,
PCC's & Partners lunch See detail next page note M 35$
Transport
Fri Coach - PDG's Dinner (return) See detail next page note N 10$
Sat Coach - Tropical Gala Ball (return) See detail next page note N 10$
Parking FREE See detail next page note P
Souvenirs & Merchandise POLO Shirts souvenir of Townsville 2018 Convention
Unisex style - raglan sleeve
Available Monday of Convention30$
convention pins 5$
wine glass coolers 5$
stubby coolers 5$ Giant Raffle - $1 per ticket 1$
Sub Total
LESS "Early Bird" Registration
TOTAL
size XS - 14 S - 16 M - 18 L - 20 1XL - 22 2XL - 24 3XL - 26 4XL - 28 5XL - 30
quantity
Lions MD 201 Australia & Papua New Guinea 66th National Convention Townsville 4-7 May 2018
FORM 3
Event Event Detail Descriptions - in accord with Page 2
A Tree Planting - FREE Activity Free activity with free sausage sizzle - 9am to noon - Location : initially 9am UNESCO Park
, cnr Angus Smith Dve. and University Dve.Annandale ; then 2nd site Marabou Dve.,
Annandale - CONTACT John Muller - 0407114687 OR [email protected]
B Lioness dinner Venue : Townsville Yacht Club - 6.30 to 10pm - $50 ph., two course alternate
drop sit down dinner, Theme : Tropical , CONTACT Jo Lynes on 0409490606 OR
C Lunch Friday / Saturday /
Sunday
approx. 12.30 to 1.30 - Your choice @ your cost at several outlets incl. ham or
chicken salads, various sandwiches, pies , sausage rolls, hot chips, cold drinks etc
D Informal Reception Venue : Lawns at the Townsville Entertainment Centre - 5pm to 8.30pm - $27 PH, Boxed
individual serve - either Thai chicken curry & rice OR Beef and mushroom red wine
casserole (GF & LF) plus 1st drink (beer, wine or soft drink) - cash bar thereafter +
entertainment - Townsville brass band + others
E Leos Night Out Laser tag and 10 Pin Bowling - from 7pm- Cost t.b.a. - CONTACT MD Leo Chair
Toni Lanphier ph 0427794342 OR [email protected]
F PDG's Dinner Venue : Rydges Southbank Function Room - $65 ph., 5.45 / 6.30 pm Welcome drink on
arrival wine, beer or softdrink - then cash bar - DRESS - Black tie / dinner suits w/- medals
- CONTACT Jim Nicholson ph 0407154721 OR [email protected]
G Key Members and First
Conventioneers' Breakfast
Venue : The "Ville" - 7.30 to 8.30 - Open to all conventioneers - motivational
speaker - $25 ph - breakfast platters of hot & cold food served to tables
H Tropical Gala Ball Venue : Townsville Stadium, Murray Sporting Complex - 6 to 6.50 f/ship - then 6.50 to late
- Tropical Formal - Men - long trousers optional jacket & tie, Ladies - cocktail dress -
CONTACT - Paul Clay 0418192411 - Greg Jackson 0402808060
J District Functions From 6pm onwards - organised by individual District Teams - Reference your
Cabinet Secretary OR District Website for details
K Convention Lunch Monday -
by Lions Clubs
12.00 to 1.30 - Lions BBQ @ $15 per head of steak or chicken, sausage , salad,
breadroll, juice popper, fresh fruit
L Past & Present Cab Secs , Cab
Treas, & current D.G.'s &
Partners lunch
Venue : The "Ville" - 12.15 to 1.30 - $35 - table served hot meal - for designated
guests only
M Council Chair, International
Director, PIP, PID's, PCC's &
Partners lunch
Venue : The "Ville" - 12.15 to 1.30 - $35 - table served hot meal - for designated
guests only
N Transport Available for the Tropical Gala Ball and for the PDG's Dinner. Cost $10 PH
Return. Pickups accommodation routes along Bowen Road, Palmer Street, the
Strand and the "Ville"
P Parking FREE Parking - available daily at the Dean Street Car Park, with free shuttles to the
Convention Centre as follows :- Thursday for Registrations 12 noon to 5pm, Friday to
Monday from 8 to 10.30 and from 4.30 to 6pm (till 8.30 Friday night for Informal
Reception) - Parking at Convention Centre is complimentary for conventional vehicles only
(no vans, mobile homes)
Lions MD 201 Australia & Papua New Guinea 66th National Convention Townsville 4-7 May 2018
REGISTRATION FORM Registration closes Friday 20th April
FORM 4 - Payment Details
Electronic Funds Transfer BSB : 633108 ACC NO : 155764038
please attach copy of banking receipt with registration forms
Email Forms (1,2 & 4 ) to : [email protected]
OR
Payment by cheque
make cheque payable to : Lions MD 2018 Convention
mail cheque + forms to : Box 6380 Mail Centre, Mackay, Qld 4741
OR
Payment by credit card
Card Type
Card Number
Expiry date Card Verification
Name on card
Signature
Chairman Registrar
PDG Di Pyers PDG Gary Kenny
0428 580 081 0402 081 960
Secretary Treasurer
Greg Jackson Kevin Gietzel
0402 808 060 0412 724 031
-- Preferred Method of Payment Electronic Transfer --
