Margaret Healy Leadership Assembly

Registration

Name: _______________________________________________________________________________

Address: _____________________________________________________________________________

____________________________________________________________________________

Telephone: _________________________ Fax: ____________________________________

E-mail: _______________________________________________________________________________

1. Room requirements (Thursday-Saturday for normal Assembly activities):

___ Tuesday (March 25) * ___ Saturday (March 29)

___ Wednesday (March 26) * ___ Sunday (March 30) *

___ Thursday (March 27) ___ Monday (March 31) *

___ Friday (March 28)

* $35 per night. If other days are required, please make a note.

2. Language preference (for discussion groups): ___ Spanish ___ English

__ Check here if you are bilingual

3. Travel Arrangements (Please indicate how you will be getting to the Assembly):

___ Arriving by car on ______________ at approximately _____________

(Day) (Time)

___ Arriving by air in Atlanta/Columbus on _______________ via _______________ at _____________

(Circle one) (Day) (Airline) (Time)

IF ARRIVING BY AIR, PLEASE COMPLETE ONE OF THE SECTIONS BELOW:

__ Check here if you will arrange your own transportation to Holy Trinity

Note: If you are renting a car in Atlanta and are willing to take other passengers, please provide the information below. Someone will contact you:

Departure Date: ___________ Flight departure time: ____________

__ Check here if you need a ride to and from the airport, and provide the information below:

Departure Date: __________ Flight departure time: _____________

Mail completed form by February 27, 2003 to:

Pat Regan, MCA

3929 Greencastle Rd. #207

Burtonsville, MD 20866 (U.S.A.)

(or e-mail the information to patregan3@comcast.net) RegistrationForm_English