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Edmonton - Registration

5th North American Chevra Kadisha Conference 

June 10-12, 2007 - Edmonton, Alberta, Canada

  Please provide your contact information:


Title

First Name

Last Name
Organization Web-Address
Address
Address2
City State or Province
Country     Zip or Postal-Code
Work Phone

Cell Phone

Home Phone
E-mail   Fax

 
 
 
 



When will payment be received for your registration? 

Early (Before April 1)          Regular (Before June 1)              On-Site (June 1 and after)


Check the type of registration you want 

Type   Registration
Before April 1
Before  June 1
June 1 and after
F Full Conference  - Sunday (1-9), Monday (9-9), Tuesday (9-1) including Sunday dinner; Monday breakfast, lunch, dinner;  Tuesday breakfast, lunch

325

350


375


Please consider membership in Kavod v'Nichum. Your Chevra Kadisha can join for $180. Individual membership is $36 or $72. Your support of Kavod v'Nichum enables us to continue to provide the website, phone assistance and North American conferences.
 

No  Yes, Chevra Kadisha membership in Kavod v'Nichum $    180
No  Yes, Shomer individual membership in Kavod v'Nichum $    72
No. Yes, Chaver individual membership in Kavod v'Nichum $ 36
No. Yes, I would like to make a tax deductible donation of an additional $

Registration amount due (from above table) $

 Please fill in the total amount due $


   Please let us know when you will arrive at the conference - choose one of the following options:

I will arrive before Shabbat on Friday and I would like to attend services
I will arrive before Shabbat on Friday and want to stay with a local family
I will arrive for the conference in time to register by 11am on Sunday.
I'm not sure when I will arrive.

I will have local transportation.


   Please let us know where you will be staying for the conference - choose one of the following options:

I will be staying at the Fantasyland Hotel
I will be staying at the West Edmonton Mall Inn
I will be staying at another local hotel - which one?
I will make my own local arrangements with family or friends
I would like home hospitality if it can be arranged (it is limited, but we'll try).
I don't know yet where I'll be staying.


   Please let us know about your food needs for the conference - Kosher food (under supervision) will be served 

No. Yes, I am a Vegetarian.
No. Yes, I am allergic to certain foods. Please list:
No. I need certain types of foods - e.g low salt, high protein. Please list below:


   Please indicate if you can walk steps

I can walk steps. I need to use the elevator. I need other physical accommodations. Please list:

Other issues or comments:


   Please tell us how you will pay:

I will pay by credit card. Press the Registration button and print the acknowledgement for your records.  Then follow the Link to Credit Card Payment.  

I will pay by check. Press the Registration button and print the acknowledgement for your records. Then send a copy of your acknowledgement with your check (made out to Kavod v'Nichum - Chevra Kadisha Conference) to:

Kavod v'Nichum
8112 Sea Water Path
Columbia, MD  21045

Please be patient after pressing the Registration Processing button...

It may take a minute or two to process this form! 

  

 


Copyright © 2002-2006 Kavod v'Nichum. All rights reserved.
Revised: February 23, 2007
Jewish Funeral Practices Committee of Greater Washington