REGISTRATION FORM
Fiancé (Male) / Fiancée (Female)Name
Name on
Name Tag
Date of Birth / (d/m/yyyy) / (d/m/yyyy)
Address
Postcode
Town
State
Telephone / House -
Mobile - / House -
Mobile -
E-mail / @ / @
Religion / ------CATHOLICCHRISTIANBUDDHISTTAOISTHINDUSIKHBAHAIOTHERS (please click to select) / ------CATHOLICCHRISTIANBUDDHISTTAOISTHINDUSIKHBAHAIOTHERS (please click to select)
If CHRISTIAN or OTHERS, specify
Parish Church of
Town
Occupation
Proposed Date of Marriage / (d/m/yyyy)
How long have you known your partner? / YEARSMONTHS (please click to select)
Signature
Parish Priest
(Signature & Stamp) / Note:· Registration Fee: RM400 per couple
· Deposit of RM200 payable upon submission of registration form (please refer to Terms and Conditions for Account Number). Balance of RM200 payable upon reporting for the weekend.
· Send completed form (all details) to Darin & Sharon Moreira either by:
è Email (preferred):
è OR normal post: 9, Lebuh Seri Genting 9, Metro Residence, 11000 Balik Pulau, Penang.
(DO NOT send by registered mail / Pos Laju / courier).
· All forms must be endorsed by parish priest and attached with cheque / bank-in slip / cash deposit machine receipt / Internet banking transfer acknowledgement as payment / proof of payment of the deposit.
· For enquiries: Tel: 016-4129696 (Darin), 016-4989696 (Sharon) (after 8pm).
· Registration closes 6 weeks before a scheduled EE Weekend or when a Weekend is full, whichever is earlier.
For administration
Registered for Weekend No:
Attended Weekend No:
Terms and Conditions
1. Registration fee is RM400 per couple.
2. A deposit of RM200 per couple is payable upon submission of registration form. Registration forms will not be processed without a deposit.
3. Payment of deposit can be made by:
· Directly crediting Account Number: 14100006034 at any Hong Leong Bank branch / cash deposit machine. Account Name is “Catholic Engaged Encounter”. Internet banking transfers can also be made. Please attach the bank-in slip / cash deposit machine receipt / Internet banking transfer acknowledgement with your registration form as proof of payment.
· OR Cheque payable to “Catholic Engaged Encounter”. Please add RM0.50 for outstation cheques.
4. Please do not send postal or money orders.
5. The deposit may be refunded in full (withdrawal of registration) or carried over for a future EE Weekend (once only) if no less than 7 (seven) calendar days notice is given prior to the commencement of the participating couple’s registered EE Weekend.
6. The deposit will be forfeited if less than 7 (seven) calendar days notice is given. In this case, another deposit will be payable upon the next registration.
7. The balance of RM200 of the registration fee is payable (in cash only) upon reporting for the EE Weekend.
2016 Weekend Dates
· 22-24 January 2016
· 8-10 April 2016
· 24-26 June 2016
· 2-4 September 2016
· 11-13 November 2016
Website: ceepenang.org Page 1 of 2 Revised: 1 November 2015