2005 CFC Regional Workshops
Workshop and Hotel Registration Information

(For Your Record Purposes Only)

When making your reservations, please refer to the meeting as the CFC/OPM Workshop. This will help ensure conference rates and availability. The hotels' phone numbers and deadline dates are listed below.

Hotel reservations must be made separately from conference registration and are the responsibility of each participant. You must use the group name (Community Health Charities/CFC) when making your reservation to receive the discounted room rate.

Hotel Name     _______________________________________

Date reserved     _____________________________________

Confirmation Number     _______________________________

Room Rate     ______________________________________

Save This Form for Check-in Reference Address questions or comments to Herb Sanabria at 404-562-1393 or Linda Young at 703-528-1007.

NATIONAL CFC REGIONAL WORKSHOP
Registration Form

The registration fee for this year's workshop is $200.00. A late registration fee of $250.00 per person will apply for all those who register after 2/14/05 for Miami and 3/05/05 for San Diego.

Please submit one registration form for each registrant. Return form(s) with credit card receipt or check, money order, or government voucher made payable to CFC National Committee. Please include all attendee names(s) on checks, money orders, government vouchers, or credit card receipts. If the registration deadline has passed, please call for space availability before making travel arrangements.

If using a government training voucher, please submit appropriate copies with the registration forms for attendance verification and direct payment from the sponsoring agency. The name and address of the person to be billed MUST be provided and attached to registration form(s).

For additional information, please contact Herb Sanabria @ 404-562-1393 or Linda Young @ 703-528-1007.

        Name: ____________________________Organization:_____________
        
        Mailing Address: ______________________________________________
        
        Telephone # 	________________	Fax#______________________
        
        E-MAIL:______________________
        
        CFC Name___________________ CFC Code___________
        
        Affiliation:  ___PCFO   ___LFCC   ___Federation/Charity_ __Volunteer 	__Guest
        
        Spouse/guest wishing to attend meal functions____$65.00   
        
        Will you attend the Sunday Workshop? 	__Yes	__No
        
        Will you need special accommodations or meals?  If so, please list:
        

Select the workshop you will be attending

        Miami, FL __March 13-16, 2005	San Diego, CA __April 6- 9, 2005
        
        Method of Payment: __Check __ Money Order __ Government Voucher __ Credit Card
        

Make Checks, Money Orders, or Government Vouchers PAYABLE To: CFC National CFC Committee

If using credit card, go to: http://floridacfcworks.mollyguard.com or http://sandiegocfc.mollyguard.com

Mail this Registration Form with your Check, Money Order, Government Voucher, or Credit Card receipt to:

Herb Sanabria
PO BOX 2864
Atlanta, GA 30301

Refunds Will NOT be made for cancellation requested one (1) week prior to the Workshop

To download this registration form in MS Word format:

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