Diocesan Ministry Day - Registration

Diocesan Ministry Day - Registration Form

Click on Button to register:	By 8/29/08	After 8/29/08
Conference Registration	$45.00	$55.00

Personal Information
*Name:
Title:
*Parish/School/Office:
If Other, Please Specify:
*Address:
*City, State, Zip:
*Phone/Fax:
*Valid Email Required Email:
* Required Field

BiIling Information
If same as above, check here
If different, enter here

Please Select Breakout Sessions for Conference (see brochure for descriptions)
Session I:
Session II:
Session III:

Will you be attending the social reception Monday late afternoon?
Yes No

Are you available to be a volunteer for part of the Diocesan Ministry Day? Yes No

Please list any special needs: (ASL upon request)

Comments: