Mujeres Edificando Destinos Mujeres Edificando Destinos

Hoja de Inscripcin | Sbado, 4 de noviembre 2017-9:00am-4:30pm Registration Form | Saturday, November 4, 2017 - 9:00 AM 4:30 PM
Congregacin Len de Jud, Boston, MA Congregation Lion of Judah, Boston, MA

No se aceptarn inscripciones despus del 29 de octubre, ni el da del Registrations will not be accepted after October 29th, nor on the day of the
retiro. retreat.
Tu inscripcin no es reembolsable pero si es transferible con la Your registration is not reimbursable, but it is transferable with ticket
presentacin del boleto. presentation.
Lamentamos no permitir nios en el evento. We regret not being able to allow children at the event.
Otra opcin para inscribirte es electrnicamente a travs de PayPal You can also register through PayPal at: www.leondejuda.org/node/8590
www.leondejuda.org/node/8590

Por favor use una hoja por cada persona que se est inscribiendo y escribe Please print and use one form per registrant.
en letra de molde.
Name: __________________________________ Telephone: _______________
Nombre: __________________________________ Telfono: _______________
Address: _________________________________________________________
Direccin completa: _________________________________________________ number street apartment number
nmero calle # de apartamento

city state zip code

ciudad estado cdigo postal
Email: __________________________________________@________________
Direccin Electrnica: _____________________________@________________ Please provide your email address (all information is kept confidential)
Por incluye tu direccin electrnica (no compartiremos tu informacin)

Contribucin: Marque aqu: Contribution: Please Check:

$50.00 Adultas Primera vez que asisto al retiro. $50.00 Adult First time that I attend the retreat.
$35.00 Joven (15-19 aos) Opciones de almuerzo:
$35.00 Teenager (15-19 years)
Lunch Options:
Almuerzo regular. Regular meal.
$__________ Total
$__________ Total
Almuerzo Vegetariano. Vegeterian meal
En Efectivo Necesito acceso al elevador por Cash I require access to the elevator
condicin fsica due to a physical condition.
En cheque o giro postal a nombre
de: Soy Pastora. Check or money order payable to: I am a pastor
Congregacin Len de Jud
Congregacin Len de Jud
C/o Wendy Cid
I need translation into English. C/o Wendy Cid
I need translation into English.
19 Neponset Avenue 19 Neponset Avenue
Roslindale, MA 02131 Roslindale, MA 02131