Registration

September 2024

Registration fee is due by TBD

If you have questions, contact Jannice May at 626-379-0505 or conbond@acninc.net

Booking Information
Choose Room Type
Please mark the type of room you need. The following prices are for accommodations, meals and registration fees.
- Double ($561/person) or 3 payments* of $187
- Single ($810/person) or 3 payments* of $270
- ZOOM price --- $165.00
*If you are making 3 payments, the due dates are:
1st payment — May 26, 2024
2nd payment — June 30, 2024
3rd payment — July 28th, 2024
Final payment should be received by August 11, 2024
Physical Limitations
Please indicate if you have any physical limitations that would require wheelchair accessibility or limit your stair use:
- Yes
- No
If you asnwered "yes" pleased explain here.
Dietary Needs
Please indicate if you have any dietary needs:
- Yes
- No
If you asnwered "yes" pleased explain here.
Personal Information
Name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Email
Birthday
MM slash DD slash YYYY
Anniversary Date
MM slash DD slash YYYY
Husband's Name
First Last
Years in Ministry
Husband's Status
- Active
- Retired