MMN 2018 Conference Registration Form

MEMBER INFORMATION

Name: ______________________________________________ Gender: M ___ F___

Address: ____________________________________________

City: _______________________ State: ____________ ZIP: ____________

Phone: ________________________ Cell: _____________________

Email: ________________________________________

Alternate Address: _______________________________________________

Alternate Phone: _________________________________________

Other Family Members on same registration form:
Name:___________________________ Relation: _________ Gender: M ___ F____

Name:___________________________ Relation: _________Gender: M ___ F____

Any dietary or physical special needs? _____________________________

LODGING INFORMATION:

Attendees are encouraged to share rooms to lower individual conference costs.

Full registration includes 3 nights lodging, all meals (Thursday dinner thru Sunday breakfast) and program expenses

No full registrations can be accepted after July 6th. Only commuter registrations will be accepted after that date. Late registrants will be responsible for their own lodging accommodations..

Please indicate number of people at each rate below if more than one person is being registered with this form.

_____ Single Occupancy Room: $550.00/person ($575 after June 29th)

_____ Double Occupancy Room: $350.00/person ($375 after June 29th)

_____ Triple Occupancy Room: $275.00/person ($300 after June 29th)

_____ Commuter Registration - 2 Days $150/person ($175 after June 29th)
Includes 2 lunches, 2 dinners and program expense

    _____ Commuter Registration - 1 Day: $85/person ($100 after June 29th)
                 Includes 1 lunch, 1 dinner and program expense
                 Friday: _______    Saturday: ______

If you are registering for a Double or Triple Occupancy room, who will you be rooming with: ____________________________ or "assign me as needed" _______

If you do not have a preferred room-mate - we will match you up with others as needed
to maximize the room usage and minimize the costs.

TRAVEL INFORMATION

Travel:

I will arrive on ____/_____/____ at _____________ a.m./p.m. on Airline ____________

Flight # ________________ . I need transportation from the airport. Y __ N __

I will depart on ___/_____/_____ at _____________ a.m./p.m. on Airline ____________

Flight # ________________
Free Shuttle available from Love Field airport. I need transportation to the airport. Y _ N _

I will be driving and arriving at approximately ______a.m./p.m. on _____________

-My Travel Plans are not complete yet, but I will notify you when I know: ______

MALAWI MISSION NETWORK INFORMATION

Affiliation:
Congregation Name or other organization represented: __________________________________________

Are you a registered member of the Malawi Mission Network? __ YES __NO

Membership is not required to attend. Conference registration will include registration in the network.

If you are NOT already registered as a member, please tell us what your connection to or interest in Malawi is.. Why are you interested in attending the conference?

______________________________________________________________________

Optional Contribution to Support the Malawi Mission Network Conference

We try to keep the cost down to encourage maximum participation, but a little supplement from those able can help support the Conference. An extra contribution can help for:

1. Travel & accommodation expenses to bring 1 or more CCAP representatives from Malawi.
2. Travel & accommodation expenses to bring Mission Co-Workers already in the USA to the conference.
3. Scholarship help for those unable to afford the conference.

Amounts to consider: $50 _____ $100 _____ OTHER: $______