Register for the Women's Spring Renewal Retreat, April 22-24 2005

REGISTRATION FORM for the Spring Retreat for Women
April 22 - 24, 2005

Please PRINT OUT THIS PAGE, FILL IT IN, and RETURN IT WITH YOUR CHECK to:

Connie Habash - P O Box 121 - Menlo Park - CA 94026-0121

REGISTRATION FORM - Spring Retreat for Women

Name(s)_________________________________________________________

Email ___________________________________________________________

Address_________________________________________________________

City_____________________________ State________ Zip _______________

Phone___________________________________________________________

Choice of Roommate (optional)________________________________________

Fees: Early Registration (by March 25th):
	$255/person, dorm (4-7 persons) occupancy, shared bath $280/person, triple occupancy, shared bath $310/person, double occupancy, shared bath $350/person, single occupancy, shared bath After March 25th - add $30

First choice for accomidations:________________________________

Second choice for accomaditions:_____________________________________

Please find enclosed $_____________ for __________ person(s)

Please make checks payable to Connie Habash

Please submit registration by 3/25/05 for the discount, and not later than 4/17/05 to:
Connie Habash
P.O. Box 121
Menlo Park,
CA 94026-0121

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