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International Center for Law and Religion Studies
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2025 New Zealand Regional Conference Registration Form
Salutation (e.g., Mr., Ms., Mrs., Dr., Prof., Rev.)
Given Names
(Required)
Surname or Family Name
(Required)
Honorific
Gender
(Required)
Male
Female
Prefer not to answer
Birthdate
(Required)
DD slash MM slash YYYY
Preferred Name on Badge
(Required)
Name as it should appear on the program
(Required)
Job Title/Position
(Required)
Organization Name
(Required)
Address Line 1
Address Line 2
Address Line 3
City
State/Province
Postal Code
Country
(Required)
Preferred Phone (include country and area code)
(Required)
WhatsApp Number (include country and area code)
(Required)
Preferred Email
(Required)
Alternate Email
Primary Language
(Required)
English Fluency
(Required)
Present in English
Fluent
Conversational
Reading
Need Interpretation
Religious Affiliation
Assistant Name
Assistant Work Phone
Assistant Email Address
Dietary Restrictions
Other Special Needs
Accompanied by spouse/guest?
Yes
No
Spouse/Guest's Given Name(s) (if attending)
Spouse/Guest's Surname or Family Name (if attending)
Please note: Guest travel and additional hotel room costs are paid by the guest and not by the conference organizers.
Will the delegate be sharing a hotel room with their guest or does the guest need a separate hotel room?
Shared Room
Separate Guest Room
I have emailed (or will email) a scanned copy of the picture page of my passport.
Yes
No
I have sent or will send a Hi-Resolution headshot of myself to
[email protected]
Yes
No
I am willing to receive further communications from the organizers (e.g., program information, flight arrangements, etc.)
(Required)
Yes
No
Please write a brief biography in paragraph form (limit to 150 - 200 words)(Can cut and paste from another document)
Link:
View 2025 New Zealand Regional Conference Terms and Conditions
Consent
(Required)
I agree to the above terms and conditions relating to the event.
I accept the invitation to participate in the 2025 New Zealand Regional Conference.
The following fields only apply to those that are traveling internationally to the event.
Full Name on Passport
Passport Number
Passport Issue Date
DD slash MM slash YYYY
Passport Expiration Date
DD slash MM slash YYYY
Passport Place of Issuance
Passport Issuer
Departure City (and Airport)
Return City (and Airport)
Preferred Airline
Preferred Seating
Aisle
Window
Frequent Flyer Number (if available)
Known Traveler Number (if available)
Do you need assistance to process visa?
Yes
No
Please specify visa assistance needed