IC/FETC 2011 REGISTRATION January 31 (Eve) - February 3, 2011

IC/FETC CONFERENCE REGISTRATION FORM FEES

Name Registration Fee $ Title Tues Box Lunch ($15 each) $

Parish or Org. Tues Networking Dinner ($25 each) $ Address Wed Networking Dinner ($25 each) $

City/State/ZIP

Phone/FAX Email TOTAL.................................$ (If a registration is cancelled a non-refundable fee Please list any special needs, including dietary needs: of $50 will be retained)

IC/FETC REGISTRATION:

Full registration includes Monday evening social, Tuesday Make check payable to sessions, and FETC Sessions/Exhibits Wednesday and Thursday. INTERACTIVE CONNECTIONS Mail Check and this form to: Before 12/1/09 After 12/2/09 Full Member Registration $200.00 $225.00 Caroline Cerveny, SSJ Non-Member Registration 250.00 275.00 INTERACTIVE CONNECTIONS Wed/Thurs Dinner 25.00 25.00 557 Dove Terrace West Tuesday Box Lunch 15.00 15.00 Oldsmar, FL 34677

ROOM RESERVATIONS (Deadline 12/15/09) Note: If you are ONLY interested in the

In order to be together as a group, a block of rooms Pastoral Technology Summit that is being held has been reserved at the Doubletree Resort Orlando -- on Monday evening thru Tuesday please register International Drive, at the rate of $89.00 + TAX. at - http://intconnect.eventbrite.com To reserve your room, call Doubletree Resort 800-327-0363. The special rate of $89.00 + taxes is available (3) days pre- and post- conference dates. Rooms cancelled after 12/21/2010 may incur cancellation fees. Note: A room reservation at the Doubletree Resort may not be available after 12/15/2010.

Your registration form and payment must be postmarked no later than December 31, 2009 . All cancellations and requests for REFUNDS will be subject to a $50 administrative fee and $5/person fee and must be postmarked by January 3, 2010. No refunds will be given after that date.

Should you have any questions or need further information, please contact Caroline Cerveny, SSJ at:

727-744-4684 or c.cerveny@verizon.net