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2012 Religious Leaders Gathering

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Title *                   

First Name  *            

Middle Initial          

Last Name  *        

Address                                   

City                           

State  *                        

Zip/Postal Code  *    

E-mail Address   *     

Office Phone          

Communion  *       

Position                  

Home Phone           

 

REGISTRATION FEE

Fee does not include overnight accommodations. Reservations with The Nittany Lion Inn at 800-233-7505, or online hotel reservations through our Web site.

  $125.00 per person     

 

Total Payment/Gift

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Credit Card Registration    

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For your protection, please call 717.545.4761 (Monday-Friday, 9 a.m.-4 p.m.) and we'll process your credit card payment over the phone. 

 

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Pennsylvania Council of Churches 900 S. Arlington Avenue, Suite 211A, Harrisburg, PA 17109-5024

Telephone 717.545.4761 Facsimile 717.545.4765 E-mail pcc@pachurches.org 

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