Registration Form ~ Page One: Contact Information; The 2012 AAIF Biennial Conference

The 2012 AAIF Biennial Conference

Collegeville, MN

July 13 (5 PM) – July 15, 2012 (1:30PM)

“Interchurch Families: ‘Listen…with the ear of your heart”

Registration Form ~ Page One: Contact Information

Please print clearly

Name:________________________________________

Special Dietary Needs ________________________

Denomination:__________________________

Email Address: ___________________________________________

Phone Numbers: cell (      ) _________________     (other) (        ) ________________

Name:_________________________________________

Special Dietary Needs __________________

Denomination:__________________________

Email Address: ___________________________________________

Phone Numbers: cell (        ) ___________________ other (       ) _____________________

Child’s Name:___________________________________

Special Dietary Needs _______________________

Age:_________

Child’s Name:___________________________________

Special Dietary Needs _______________________

Age:_________

Child’s Name:___________________________________

Special Dietary Needs _______________________

Age:_________

Please attach another page if more space is needed for information about children more than 3 children

Mailing Address:____________________________________________Apt.#________                House Number + Street Name or P.O. Box Number

______________________________________________________________________ Name of City + State/Province + Zip Code + country

Do you plan to arrive early and wish to stay on campus?  Date of arrival:  July_____2012

Do you plan to stay after and wish to stay on campus?  Date of departure: July_____2012

Those people who have indicated their interest either in arriving early or in staying on after the end of the 2012 AAIF Conference, may contact CSB/SJU to make those arrangements directly after sending in your registration materials. CSB/SJU has asked that AAIF provide them with a list of those people from our registration forms.

After you have sent your registration form. You should receive confirmation via email. Then if you wish to arrive early or to stay after the 2012 AAIF Biennial Conference at CSB/SJU -~ ~ Please contact:   jwubbels@csbsju.edu

Please copy and paste this page to be mailed in with your registration form, signed waiver, and payment in the same envelope.