2011 Conference Registration Form
PERSONAL INFORMATION:
CHURCH INFORMATION
Name:

Address:

City/State/Zip:

Phone:

Alt. Phone:
Name:

Guest of:

City/State:

Pastor's Name:


email:
Conference Registration Information
$132.00 Registration includes Fri, Sat dinner buffet.  Saturday & Sunday Breakfast.  To pre-register make check payabale to St. Samuel Temple and mail, or come in person to 8749 S. State Street, Chicago IL 60619.before April 21st.
Leave no fields blank in these sections.  Use n/a if not available.
Sheraton Suites
121 Northwest Pointe Blvd.
Elk Grove Village, IL 60007
Book Room
By Phone (847) 290-1600
or
Online - Click Picture, or link

ROOM $89.00/NIGHT + Tax
Friday & Saturday

Saturday only:
www.sheratonsuiteselkgrove.com/
Full Conference Pkg. $132.00
Saturday Pkg including Music Workshop $50.00
Add Saturday Dinner & Concert add'l $25.00
Music Workshop Only $25.00
I Am Booking A Room
Not Booking A Room