2007 central pa conference schools of Christian mission

 

2007 Registration Form

Name ________________________________________________

 

Address ______________________________________________

City,

State, Zip _____________________________________________

 

Phone (_______) ____________ - _________________________

Email ________________________________________________

 

Adults Only

 

Roommate Preference __________________________________

 

4-DAY ADULT SCHOOL:

c Adult Resident $195

c  Adult/Single Room $225

c  Commuter with lunch & dinner $100

c  Child (K-5) Resident $125; Completed ______ grade

c  Child (K-5) Commuter $65; Completed ______ grade

c  Preschool $60; Birthdate ______________________

Adult accompanying children _____________________________

 

YOUTH SCHOOL:

c  First youth  $175            c  Additional siblings $90

Grade completed __________

Roommate preference __________________________________

 

FAST TRACK SCHOOL:

c  Adult Resident $130

c  Adult/Single Room $150

c  Commuter with lunch & dinner $65

c  Child (K-5) Resident $75; Completed ______ grade

c  Child (K-5) Commuter $35; Completed ______ grade

c  Preschool $40; Birthdate ______________________

Adult accompanying children _____________________________

 

THURSDAY SAMPLER DAY:

c  Registration with lunch $30

 

NOTE:  This form must be mailed to the Registrar along with

             payment to hold your spot at the event.

Each participant must register on a separate form.

            

Make checks payable to:

 

CPC SCOM

(Central PA Schools of Christian Mission)

Mail registrations to:

 

Mrs. Soonseeah

    Trostle, Registrar

502 Ohio Avenue

Lemoyne, PA  17043

 

Phone (717) 737-7156

 

Registration Deadline

June 12, 2007

 

No refunds after

June 12, 2007