9th Session of Conference Women’s Fellowship and Adult
Fellowship
Combined Annual Retreat, Chinese Methodist Church in Australia
澳洲基督教華人衛理公會 年會婦女團契及年會成年團契 第九屆聯合退修會
Orchard Glory Farm Resort
41 Mooliabeenee Road, Bindoon WA
2/12/2012 – 5/12/2012
申請表Application Form
(請選擇適當的方格Please tick the appropriate box)
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姓名(中文) |
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性別 Gender 男M☐ 女F☐ |
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(English) Surname |
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First Name |
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年龄 Age |
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所操言语 Spoken Language(s) |
华语Mandarin☐ |
英语English☐ |
其他Others☐ |
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地址 Address (English） |
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电话 Telephone 办公室 Office |
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住宅 Res |
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电话 Telephone 手提 Mobile |
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电邮Email |
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所属堂会 Affiliated Church |
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緊急聯絡人及電話號碼Emergency Contact Person & Tel No :
需要大會提供特別安排?(請註明以便大會儘力安排。如 : 對食物敏感)
Do you have any special needs (e.g. dietary requirements)? Please specify, as we will try our best to accommodate.
在退修會內,本人願參與所安排的活動並願遵守牧者的指導。
I agree to participate in all the programs and to follow the advice of the ministers during the Retreat.
與 會 者 簽 署Signature of Participant
日期 Date
