IMPORTANT! You must PRINT this form and MAIL with your check to:

Conference Registration
Queen of Peace Ministries
PO Box 761
Notre Dame, Indiana 46556
If you encounter problems printing the form, please call (574) 288-8777 or e-mail us with your mailing address, and we will send you printed registration materials.

CONFERENCE REGISTRATION - PRINTABLE WEB FORM

2008 NATIONAL CONFERENCE ON MEDJUGORJE
May 23 - May 25, 2008

  

(Please feel free to duplicate and distribute this form!)

Please Print:
Name___________________________________

Address_________________________________

City_________________ State___ Zip_____

On-site registration is an additional $10 where indicated
#___Adults @ $50 ($60 on site)
$______
#___Married Couples @ $90 ($100 on site) $______
#___Youth (12 - 18) @ $20 $______
#___Children (11 & Under) @ $5 $______
***Special Family Rate @$100 ($110 on site)
#____Adults  #____Children
(Family is defined as parents and dependent children living under the same roof)
$______
#___Priests & Religious no charge
Box Lunches:
  #___ Saturday@ $12.40 $_____  
  #___ Sunday@ $12.40 $_____  
Total Meals $______
Offering to Support the work of the Conference $______
Total Registrations, Offering, & Meals $______

Daytime Phone:

(____)_________________

E-mail
___________________________

Total Persons
Registering
 

List additional names and addresses on a separate sheet (or photocopy this form). Please indicate: Priests, children, etc.

Special Needs Seating: See "Special Needs". Please describe the nature of need so we can better accommodate you:

Name:________________________

Nature of Handicap:______________

______________________________

Attending in your own wheelchair (See special needs):
  Yes____   No_____

Escort:_______________________

Return this form with your check (U.S. funds only, payable to Queen of Peace Ministries) to:
Conference Registration, Queen of Peace Ministries, P.O. Box 761,
Notre Dame, Indiana 46556

Back to REGISTRATION INFORMATION PAGE