Special Event Registration Form

Urban Ministry Day

Monday, May 21, 2007

9:00 am  - 3:30pm

$10 per person
 

(Registration Deadline: Monday, May 14, 2007)

 

Complete this form (online registration requires payment by credit card) and click on "Submit" below to register online, or .....

Make a copy of the completed form  and mail to St. Bernard’s School of Theology & Ministry, 120 French Road, Rochester, NY  14618, Attn: Ellen Morningstar, Registrar, with a check payable to "St. Bernard's" or credit card information.

Last Name:      First Name:   

Address:       
City:    State:    Zip Code: 

E-mail:  Day Phone:   

Parish: City:   
Ministry Title:

 Special needs (ASL interpreting, dietary, etc):  
    


Registration Fee: $10

Payment information must accompany online registrations.

Billing Instructions:      

American Express  Discover Card/Novus  MasterCard  VISA
 
Acct #    Exp. Date:    
Name on Card:


   

St. Bernard's School of Theology and Ministry
120 French Road
Rochester, NY 14618
Phone: (585) 271 - 3657
Fax: (585) 271 - 2045
 

 

Albany Extension Site
40 North Main Avenue
Albany, NY 12203
Phone: (518) 453 - 6760
Fax: (518) 453 - 6793