North American Academy of Ecumenists
www.NAAE.net
2003 Conference
Registration Form
PRINT and MAIL or FAX This Form

"Christ and Culture Revisited"

Cost: Inclusive Room and Board and Registration (All fees in US Dollars)
$160 before August 1, 2003
$180 after August 1, 2003
Special student rates and scholarships available.
                                 

Name:  ______________________________________________________________________________

Address:           ________________________________________________________________________

City, State/Province:     _________________________        Zip/Postal Code: ________________________

Religious Affiliation:       ________________________ Status:__ Clergy  __ Laity  __ Religious __ Student

Institution:         ________________________________________________________________________

Telephone: (Office)       _________________________ (Home) __________________________________

Fax:      _____________________________________ E-mail ___________________________________

I will attend:  ___ Friday only                                                    $30
                     ___ Saturday only                                                  $60
                     ___ Full Conference with accommodations        $160 ($180 after August 1)
                     ___ Full Conference STUDENT/Fixed Income   $100
                     ___ Church Tour of Montreal                               $20

All fees in US Dollars.  Make all checks payable to: The North American Academy of Ecumenists (NAAE)

Print and Send this Completed Registration with Fee to:
Andrée Thivierge
Canadian Centre for Ecumenism
2065 Ouest, rue Sherbrooke
Montreal, Canada H3H 1 G6
Tel: 514-937-9176
Email:
Fax: 514-937-4986