The 19th  C. S. I. North American Family Conference
Hosted by UCMC
August 11 - 14, 2005
Theme: 

"  Committed to Love and to Transform’ based on Micah 6:8   "

 

 REGISTRATION FORM

Please Stop at the Business Center for Conference registration. Please let us know if you are coming early to the conference, so that we can arrange accommodation for you .  There will be $55 per day charge.
Last Name First Name Age Sex Relationship Group Assigned
Address:
City:
State:
Zip Code:  
Email:
Phone:
Church Affiliation:

CONFERENCE FEE SCHEDULE

Category Fees # of Attendees Amount
Family of 5 ( 2 adults with children below 13) $780.00X  
Family of 4  ( 2 adults with children below 13) $680.00 X  
Family of 3 ( 2 adults with one child below 13) $525..00 X
2 adults in one room  $450.00 X  
Single adult in a room  (Ages 13 and above) $300.00 X  
Children 4 and under  for the entire conference N/C  X  
Conference Registration Fee (Per attendee) $25.00 X

Rate # of Days Amount
Grand Total:

Make check payable to "CSINA" and mail this registration form with your
Full payment ( in US funds ) before July 15th, 2005. We may not be able to guarantee sleeping rooms after July 30th, 2005. Please complete the form and fax it to the following number.

Make Check Payable to:

CSINA
P. O. Box 40278
Glen Oaks, NY 11004-0278

Convener: Babu Philip Phone:  847-965-2386              Registrar: Shibu Kurian 630-805-3295 (Cell)

Treasurer: John Zachariah 516-294-4210

Print this form and FAX it to:  630-372-8893