Name:__________________________________________________________________________ Home Address:__________________________________________________________________ City_________________________State/Province:___________________________________ Zip/Postal Code:_______________Phone:___________________E-mail:________________ Congregation/Organization:_____________________________________________________ Please check here if you do not wish the above information to be published in the Convo 2000 Directory._______ Cost: The cost of the conference is $100 per person. Payment by ______ check ______ credit card: _____ Visa _____ MasterCard Card number: ________________________________ exp. Date_________ There is a $5 credit card use fee. Meal Restrictions: _____ None _______ Vegetarian _____ Veg-fish/egg okay _____ Other:_____________________________________________________________ This cost includes your meals and program. You must pay with your registration. There is a limited scholarship fund for those who find the registration fee prohibitive. Please contact us for additional information about this fund. Please make any check payable to: The First Universalist Church Denver And mail to: The First Universalist Church 4101 East Hampden Avenue Denver, Colorado 80222-7262 Additional information: Eddy Carroll 3078 W 39th Ave. Denver, Colorado 80211 firstname.lastname@example.org or The First Universalist Church (303)-759-2770 or (303)-759-2862 email@example.com The Conference Hotel is The Marriott SE which is located one mile east of the church on E. Hampden Ave. The rate is $60 per night double occupancy. This is an additional cost not included in the above registration fee. You will need to pay the hotel directly. Please call Josephine Hehnke toll free at 1-888-469-4845 to make your hotel reservation. She can also assist your with your travel arrangements. Cancellation Policy : A 50% refund will be given if notification is received by February 8, 2000. No refunds can be given after this date. Accessibility: We are committed to the full and safe participation of all participants. Please use the spaces below to tell us of any special needs you have.