《如何与青少年谈性》报名表

Full Name名字*

First Name 名Last Name 姓

Gender 性别

Male 男Female 女

Address 地址

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone Number 电话*

E-mail 电子邮件*

example@example.com

Suggestions or topics you would like to be included in the workshop期待有哪些内容?

Children's age 孩子年龄

10-1314-1819-25

Where did you hear about this event? 您如何得知此次工作坊？

本次工作坊不收费，仅接受自由奉献以支持晨光关怀机构。

-Donation via Direct Deposit
If you wish to donate by online bank transfer, please deposit your donation into the following bank account:

Commonwealth Bank of Australia
Account Name: First Light Care Fund
BSB: 062-006
Account Number: 1094 0645
Reference: Your name

-Donation via Credit Card
If you wish to support us using your credit card please click the PayPal link：

We would be grateful if you can help cover the processing fee by ticking the box under the donation amount.

* Please call (02) 9211 9988 if you need assistance to make the donation.

Registration Form《如何与青少年谈性》报名表