Registration

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Registration Episcopal Diocese of Milwaukee The 168th Annual Convention October 17, 2015 St. John’s Northwestern Military Academy 1101 Genesee Street | Delafield, WI 53018 | 1-800-752-2338 Parish ________________________

City ________________________

Voting Deputies – (LAY) NAME ____________________________

NAME ____________________________

E-mail

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E-mail

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Phone

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Phone

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NAME ____________________________

NAME ____________________________

E-mail

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E-mail

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Phone

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Phone

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Voting Deputies (CLERGY) NAME ____________________________

NAME ____________________________

E-mail

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E-mail

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Phone

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Phone

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NAME ____________________________

NAME ____________________________

E-mail

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E-mail

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Phone

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Phone

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Convention Registration Fee for Each voting Deputy = $50.00 (Includes materials, facility fees, presentations, breakfast & lunch)

Send this form and your check (payable to Episcopal Diocese of Milwaukee) to: Convention Registration c/o Episcopal Diocese of Milwaukee 804 E. Juneau Avenue, Milwaukee, WI 53202 ADVANCE REGISTRATIONS MUST BE RECEIVED AT THE DIOCESAN OFFICE BY SEPTEMBER 24, 2015.

Deputies not registered by September 24 th may register at Convention but a $10 per person late fee will apply. The Convention schedule is tight this year with limited time for on-site registrations . . . so please make every effort to register by September 24th deadline. THANK YOU!