PSWD UUMA Spring Retreat April 24-25, 2008
Registration and Payments
Name:
Address:
City:
State:
Zip:
Phone:
e-mail:
Congregation:
Needs Request
Dietary:
Accessibility:
Registration Fee for Spring Meeting
Write in amount:
UUMA Chapter Dues 2007-2008 (required if not yet paid):
Voluntary Contribution to Social Action Fund ($15 suggested).
Write in amount:
Payment Method (required):
If paying online, add $1.50 to the cost of your registration. Write in additional amount here:
Total Cost:
 

Special requests, including stipends and refunds for emergency cancellation
will be given consideration in collaboration with the Treasurer and Planning Team.
If you have questions or requests, please contact Stefanie as soon as possible
Rev. Stefanie Etzbach-Dale
1006 Pine St.
Santa Monica, CA 90405
RevSteffi@verizon.net
310-452 -9610