The 20th  C. S. I. North American Family Conference

Hosted by UCMC
June 29 - July 2nd, 2006
Last Name First Name Age Sex Relationship Group Assigned
           
           
           
           
Address:
City:
State: Zip Code:  
Email:
Cell:
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 June 15th, 2006. We may not be able to guarantee sleeping rooms after June 15th, 2006. 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: Major Daniel K. David Phone:  845-362-1727            Registrar: Shibu Kurian 630-805-3295 (Cell)

Treasurer: Mr. Thomas Kunjummen 516-359-8013

Print this form and FAX it to:  708-579-1032