Registration for Buddhist and Christian Meditation Retreat
Mail this registration form by June 21, 2013, with full fee or $100 deposit payable to PCSF, to:
Pacific Center for Spiritual Formation
Box 441
1819 Polk Street
San Francisco CA 94109
PROGRAM: Buddhist-Christian Meditation Retreat, July 21 - 26, 2013
NAME: _________________________________________ EMAIL: _______________________________
STREET ADDRESS: ____________________________________________________________________
CITY: ______________________________ STATE: _______ ZIP: _____________
TELEPHONE: Home _______________________ Cell ________________________
FEE or DEPOSIT ENCLOSED: $ __________ Scholarship donation: $ __________
HOUSING PREFERENCE (Circle one): Single ($700) Double ($600)