Workshop Secure Payment and Registration Form


Overnight Creative Photography Workshop

Fri May 29th/ Sat May 30th 2015


Accommodation – please select:
(drop down menu)

Camping $100: (select)
Mini-glamping $155: (select)
Glamping $175: (select)

Your personal details:

First name: (input)
Last name: (input)
Address: (input)
Suburb: (input)
City/Town: (input)
Postcode: (input)

Mobile number: (input)
Email address: (input)

Please share your photography dreams/ ambitions, what you seek to
gain from this course or anything else: (input)

Payment details

Payment can be made by PayPal (Visa, MasterCard or American
Express) or by Direct Deposit:

Select Payment method:

Paypal (clickable image link to PayPal)

Direct Deposit
Account number: 1058 3967

BSB: 062 014
Account Name: Mr. Joseph K. Sarkodie

Total amount (this figure automatically calculates the sum of the
workshop price and selected accommodation cost)

Submit details (button which sends all the info. through to my
email address)