5th North American Chevra Kadisha Conference
June 10-12, 2007 – Edmonton, Alberta, Canada
Please provide your contact information:
| Title |
First Name |
Last Name | |||
| Organization | Web-Address | ||||
| Address | |||||
| Address2 | |||||
| City | State or Province | ||||
| Country | Zip or Postal-Code | ||||
| Work Phone |
Cell Phone |
Home Phone | |||
| Fax | |||||
When will payment be received for your registration?
Early (Before April 1) Regular (Before June 1) On-Site (June 1 and after)
Check the type of registration you want
| Type | Registration |
Before April 1 |
Before June 1 |
June 1 and after |
| F | Full Conference – Sunday (1-9), Monday (9-9), Tuesday (9-1) including Sunday dinner; Monday breakfast, lunch, dinner; Tuesday breakfast, lunch |
325 |
350 |
375
|
Please consider membership in Kavod v’Nichum. Your Chevra Kadisha can join for $180. Individual membership is $36 or $72. Your support of Kavod v’Nichum enables us to continue to provide the website, phone assistance and North American conferences.
| No Yes, Chevra Kadisha membership in Kavod v’Nichum | $ | 180 |
| No Yes, Shomer individual membership in Kavod v’Nichum | $ | 72 |
| No. Yes, Chaver individual membership in Kavod v’Nichum | $ | 36 |
| No. Yes, I would like to make a tax deductible donation of an additional | $ |
|
| Registration amount due (from above table) | $ |
|
| Please fill in the total amount due | $ |
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Please let us know when you will arrive at the conference – choose one of the following options:
I will arrive before Shabbat on Friday and I would like to attend services
I will arrive before Shabbat on Friday and want to stay with a local family
I will arrive for the conference in time to register by 11am on Sunday.
I’m not sure when I will arrive.I will have local transportation.
Please let us know where you will be staying for the conference – choose one of the following options:
I will be staying at the Fantasyland Hotel
I will be staying at the West Edmonton Mall Inn
I will be staying at another local hotel – which one?
I will make my own local arrangements with family or friends
I would like home hospitality if it can be arranged (it is limited, but we’ll try).
I don’t know yet where I’ll be staying.
Please let us know about your food needs for the conference – Kosher food (under supervision) will be served
No. Yes, I am a Vegetarian.
No. Yes, I am allergic to certain foods. Please list:
No. I need certain types of foods – e.g low salt, high protein. Please list below:
Please indicate if you can walk steps
I can walk steps. I need to use the elevator. I need other physical accommodations. Please list:
Other issues or comments:
Please tell us how you will pay:
I will pay by credit card. Press the Registration button and print the acknowledgement for your records. Then follow the Link to Credit Card Payment.
I will pay by check. Press the Registration button and print the acknowledgement for your records. Then send a copy of your acknowledgement with your check (made out to Kavod v’Nichum – Chevra Kadisha Conference) to:
Kavod v’Nichum
8112 Sea Water Path
Columbia, MD 21045Please be patient after pressing the Registration Processing button…
It may take a minute or two to process this form!
Copyright © 2002-2006 Kavod v’Nichum. All rights reserved.
Revised: February 23, 2007