Thank you for signing up to join LBG for Community in 2018

Organisation name

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* 1. Organisation name

Website

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* 2. Website

Which category does your organisation fit into?

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* 3. Which category does your organisation fit into?

Name of person completing this registration:

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* 4. Name of person completing this registration:

I hereby confirm that my organisation seeks to become an 'LBG certified community partner' as endorsed by my CEO, and agrees to pay $3,000 plus GST to participate. 

If your corporate partner is sponsoring your participation please click 'agree' and indicate your sponsoring company's name in the next question

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* 5. I hereby confirm that my organisation seeks to become an 'LBG certified community partner' as endorsed by my CEO, and agrees to pay $3,000 plus GST to participate. 

If your corporate partner is sponsoring your participation please click 'agree' and indicate your sponsoring company's name in the next question

If your corporate partner is sponsoring your participation, please provide the company's name

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* 6. If your corporate partner is sponsoring your participation, please provide the company's name

Who should we send the invoice to? Please provide name and email if not already provided above

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* 7. Who should we send the invoice to? Please provide name and email if not already provided above

For the purposes of invoicing, please provide the relevant business address.

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* 8. For the purposes of invoicing, please provide the relevant business address.

LBG for Community Participant 1's  details

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* 9. LBG for Community Participant 1's  details

LBG for Community Participant 2's details

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* 10. LBG for Community Participant 2's details

LBG for Community Participant 3's details

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* 11. LBG for Community Participant 3's details

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