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 Address Information You may pay on the day, or we will bill you. Unfortunately, we cannot accept credit cards.
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: