ARBCA General Assembly Registration 2012
Please note that Co-Elders/Pastors should submit their registrations individually. The "Couple" rate is for married couples only.
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Number of Registrants *
Last Name(s) of Registrant(s): *
First Name(s) of Registrant(s): *
Mailing Address *
City *
State *
Zip Code *
Phone Number *
Email Address *
Name of Affiliated Church
Allergies?
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If yes, Please list:
I will be traveling by _________ to the 2012 General Assembly
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Flight Information: Arriving Airport
***PLEASE NOTE*** Transportation will only be available from Bradley International Airport***
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Arriving on:
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Arriving Airline
Flight #
Arrival Time
Will you be renting a car?
Flight Information: Departing Airport
***PLEASE NOTE*** Transportation will only be available from Bradley International Airport***
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Departing Airline
Flight #
Departure Time
Will you need transportation TO the airport?
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What is your housing preference?
(In-Home lodging is no longer available)
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Number of people planning to attend the Ladies Tea
Wednesday from 10am-Noon
Additional Comments
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