2010 Healthy Congregations Registration

November 18 & 19, 2010
Shalom Prayer Center—Mt. Angel, OR

First Name    Last name
Address:     
City       State       Zip Code:
Phone:      Email:
Congregation

Please register me for the following:

Description
Qnty
Cost
 
Early arrival package (Lodging for Wednesday and Thursday night and all meals beginning with breakfast Thursday morning and ending with lunch on Friday)
$120.00
Standard package (Meals beginning with lunch on Thursday through lunch on Friday and overnight accommodations for Thursday) $74.00
    Total: $

Payment for accommodations is due in full at the time of registration to reserve your space.

Those not qualifying for a scholarship will be invoiced and payment of the $255 Tuition fee will be due prior to October 18th.

Credit Card Information on next page

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