Coptic Orthodox
Diocese of the Southern United States
2001 Evangelization Conference Application
Dallas, Texas

"...do the work of an evangelist..."(2 Tim 5:4)

PLEASE Type or print clearly.

Name: ___________________________________________________________________

Address: _____________________________________City _________________________

State _____________Zip ________

Telephone: __________________ E-mail:________________________________________
Registration (Individuals are responsible for incidental charges.)

Arrival Day  _________________________  Departure Day  _________________________

Name of each attendee _______________________________________________________

(Spouse &  ________________________________________________________________
Children) 
_________________________________________________________________________
_________________________________________________________________________
PLEASE Circle Type of Registration: Three Day Registration includes
3 night accommodations & conference rooms
Friday dinner
Saturday breakfast, lunch & dinner

Sunday brunch & dinner

Monday breakfast & lunch

Regular Registration
$180 per adult   $475 per family    $130 per child (15 years & under)
Number of adults_____  Number of family _____ Number of children_____
Cost for adults + Cost for family + Cost for children =  _________________
Subtotal
One Day Registration    $50 per adult, youth, & child
Number of adults_____  Number of youth _____  Number of children_____

Cost for adults + Cost for youth + Cost for children =  _________________
Subtotal
_________________ TOTAL
Please make checks payable to:

Diocese of the Southern US: Evangelism
Mail checks and applications to:  Evangelization Conference 10608 Orange
Grove Dr. Tampa, FL 33618

Flight Information (Please see enclosed information)
Name: _______________________________________________ 

Number of people: ____________
Airline:     ______________________________________________________
Arrival Day, Time, & Flight #: ____________________________________________________
Departure Day, Time, & Flight #: _________________________________________