2015 STATE WOMEN’S RETREAT REGISTRATION
MARCH 27-28, 2015, MARRIOTT HOTEL, JACKSON, MS
Please Print Clearly
RETREAT COST PER PERSON: $ 40.00
GROUP CONTACT PERSON
INCLUDES BANQUET MEAL ON FRIDAY
MEAL BEGINS AT 5:00 P.M.
REGISTRATIONS MUST BE RECEIVED IN THE STATE
OFFICE BY THURSDAY, MARCH 5TH TO AVOID
$10.00 LATE FEE
NAME:
ADDRESS:
IMPORTANT:
Retreat Cost Does Not Include Lodging.
Lodging reservations must be made by
calling the Marriott Hotel at 601-969-5100
CITY
STATE
ZIP
Request CHURCH OF GOD rate
$99.00 plus taxes (est. 120.00)
OFFICE USE ONLY
PHONE
DATE RECEIVED
AMOUNT RECEIVED
EMAIL
CHECK #
NAME/REGISTRANTS
ADDRESS
CITY/STATE/ZIP
PHONE
MAKE COPIES FOR ADDITIONAL REGISTRATIONS
CASH
EMAIL
AMOUNT
ENCLOSED