Advance Registration Form for the 2004 Special Convention


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Advance Registration Form

2004 Special Convention of the Antiochian Orthodox Christian Archdiocese of North America

Hosted by St. George, Pittsburgh, Pennsylvania

Hilton Pittsburgh, Gateway Center

July 16-18, 2004

Please use this form to register in advance for the 2004 Special Convention to be held in Pittsburgh, Pennsylvania from July 16 through 18, 2004.

Every person (clergy and laity) attending this Special Convention must pay a special registration fee of $20.00, and will be issued a registration badge.  This registration badge will be required to enter all Convention events.

Please complete the following for each person who is registering in advance.  Enclose your check for $20.00 for each person, made payable to “St. George Antiochian Orthodox Church”, and mail the check to:

St. George Antiochian Orthodox Church

Convention Advance Registration

3400 Dawson Street

Pittsburgh, PA  15213-4314.

 

Parish or Mission Name, and City, State or Province

Names and Home addresses of each person requesting advance registration:

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$__________________________

Total Amount Enclosed ($20.00 x number of persons registering in advance)