189th ANNUAL COUNCIL — DIOCESE OF MISSISSIPPI — BILOXI January 29-31, 2016
CHURCH GROUP REGISTRATION Church: _________________________________________________City ___________________________________________
Please enclose check(s) totaling $115.00 per person, OR $65.00 per seminarian, seminarian spouse, college representative, young adult (non-delegate under 35 years old) or retired clergy spouse. NOTE: If clergy spouse is attending, they must be registered
Email: Email: Email: Email: Email: Email: Email: Email: Email: Email: Email: Email: Email: Email:
Seminarian
Visitor
ADDRESS EMAIL (if no email, please enter "none"
First Name (As desired for Name Tag)
Alternate
Last Name
Clergy
Make check payable to: 189th Annual Council Mail to: Church of the Redeemer, 1904 Popps Ferry Rd., Biloxi, MS 39532
Delegate
After November 1, regisration is $125.00 / $75.00 per person After January 1, registration is $135.00 / $85.00 per person CANCELLATIONS MUST BE MADE BEFORE JANUARY 14 TO RECEIVE $40 REFUND.
Young Adult (non-delegate)
Mission
College Representative
Parish
Spouse of Ret.Clergy/Seminarian