The United States Catholic Ministries Council (USFCMC), National Executive Committee Is

USFCMC NATIONAL CONVOCATION 2004

REGISTRATION FORM

______

PLEASE CHECK YOUR PREFERENCE

( ) Please place me with a Host Family

( ) Number of people in my party

DIOCESE

PARISH

Name ______Tel.# ______

Address

Email: ______

Name ______Tel.# ______

Address

Email ______

Name ______Tel.#______

Address

Email ______

Date(s) of Stay: ______

Registration Fee: at least $25.00 per participant - Check enclosed $______

Please write check to: Filipino Ministry c/o St. George Parish

( ) Please place me in a Hotel (at my own expense)

( ) Number of people in my party

DIOCESE

PARISH

Name ______Tel.# ______

Address

Email: ______

Name ______Tel.# ______

Address

Email ______

Name ______Tel.#______

Address

Email ______

Date(s) of Stay: ______

Registration Fee: at least $25.00 per participant - Check enclosed $______

Please write check to: Filipino Ministry c/o St. George Parish