registration

Yes, I want to register for the Latin American & Asia Pacific Solidarity Gathering

Latin American Solidarity Network- LASNET

Red de solidaridad con los pueblos latinoamericanos

Melbourne - Australia

1 day - $20 adult, $15 Concession, $10 Student
2 days - $30 adult, $20 Concession, $15 Student
Family pack, 2 days, 2 adults and 2 concession - $60
Children 15 and under Free

Send Money Order to LASNET, P.O.BOX 813, North-Melbourne VIC. 3051

Name

Organisation/Union

Address/ post code

Phone

Web site

Gender

Male Female (this is important for statistic-optional)

Birth Date

YYYY

(optional)

I would like to get involved in LASNET
Yes
No

I would like to help during the Solidarity Gathering
Yes
No

Our Organisation/Union would like to support/endorse the Garthering
Yes
No

I would like to help promoting the Gathering
Yes
No

I/We would like Make a donation to LASNET and the Gathering
$ 5
$ 10
$ 20
$ 40
$ 60
Any

I/we would like to help in the raffle tickets sale
Yes
No

Please add my name to the LASNET e-mail distribution
Yes
No

When is the next meeting or activity
Yes
No

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