South Central Regional Conference Registration Form
Address (inc postcode)
Have you joined in 2017?
Do you have any dietary requirements? (please specify)
Please tick all that apply.
£20 Early Bird rate (before 29th Sept)
£25 standard rate
£10 student rate
£10 claimant rate (unemployed, the dependent spouse of an unemployed, on income support, or only income is state pension)
£1 parking fee
To pay by paypal send a payment to
through your PayPal account quoting your name and address. You can also pay by cheque made payable to 'South Central Liberal Democrats' to Penny Hopkins, Registrations, 60 Potley Hill Road, Yateley, Hampshire GU46 6AG.
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