Women United in Christ Registration Form

Women United in Christ Mail-In Registration Form
Sylvia Harney October 18, 2008 9:00 a.m. - 3:30 p.m.
Community Concert Hall at Fort Lewis College
Durango, Colorado

NOTE: Mail in registrations must be received two weeks prior to the event.

Name:_______________________________________________________

Address:__________________________________________________

City, ________________________________________________

State, Zip________________________________________________

Phone:_____________________________________________________

Email address:___________________________________________

Church Affiliation:_________________________________________

Deaf or hard of hearing?______
Contact Diane Jenkins at 970-259-3531 to make arrangements for signing or if an FM system is needed.

# of tickets purchased @ 25.00:____________________

Donation:____________________

Total:____________________

Make check or money order payable to Women United in Christ and mail with this completed form to:
Women United in Christ
P O Box 95
Durango, Co 81302

Women United in Christ, Inc. is a 501(C) (3) non-profit organization.
All donations are tax deductible.