Registration for the Advent by the Sea Retreat

Mail this registration form by November 1, 2010, with full fee or $100 deposit to:

Carol Saysette, 193 W. Blythedale Avenue, Mill Valley, CA 94941

Checks should be made out to PCSF.

PROGRAM   ADVENT RETREAT, DECEMBER 3 – 5, 2010

NAME (s)  _______________________________   EMAIL  _______________________________

STREET ADDRESS  ___________________________________________________________

CITY  _________________________  STATE  ______   ZIP CODE ______________

PHONE(s)  __________________________   _____________________________

HOUSING PREFERENCE (circle one):  SINGLE ($310) DOUBLE ($260)

FEE or DEPOSIT, ENCLOSED  $ __________

DONATION TO THE SCHOLARSHIP FUND, ENCLOSED  $ _____________