Egypt HOME-DWAM Conference & Opening Ceremony of the New Hospital - February 2020
WEDNESDAY, FEBRUARY 12, 2020 UNTIL SUNDAY, FEBRUARY 15, 2020
ROOM & BOARD: $200 double occupancy / $300 single occupancy
CONFERENCE REGISTRATION FORM - DEADLINE JANUARY 15, 2020
HOME will be acquiring a hospital in Cairo, Egypt and the opening will be Saturday, February 15, 2020 at 7 pm. (The conference will end at noon of the same day)
LAST NAME *
Your answer
FIRST NAME *
Your answer
EMAIL *
Your answer
Cell phone *
Your answer
ADDRESS *
Your answer
CITY, STATE, ZIP, COUNTRY *
Your answer
NAME & EMAIL OF PERSON (S) ACCOMPANYING YOU *
Your answer
WILL YOU NEED TRANSPORTATION TO AND FROM THE AIRPORT? *
ARE YOU WILLING TO SHARE A ROOM WITH SOMEONE OR NEED SINGLE OCCUPANCY? *
PLEASE ENTER THE TOTAL AMOUNT YOU OWE BELOW INCLUDING ANY OTHER PERSONS ACCOMPANYING YOU *
Your answer
We LOOK FORWARD TO HAVING YOU WITH US AT THIS SPECIAL EVENT. You can email ngandy@homeforhim.org for more information or visit our website at homeforhim.org - ANY COMMENTS OR SPECIAL REQUESTS? *
Your answer
IMPORTANT - READ CAREFULLY - Please visit our website AFTER you click the submit button below in order to pay the above amount by clicking the DONATE tab and then the donate YELLOW button
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy