Friday, May 30, 2008 at 6:00 PM - Sunday, June 01, 2008 at 3:00 PM (PT)
A Training Retreat for Asian Pacific Islander Lesbian, Gay, Bisexual, Transgender People and Their Supporters
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Limited scholarships are available. For further information, please contact Elizabeth Leung at eleung@psr.edu
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Name: _________________________________________________________________
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Address: ________________________________________________________________
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| City: ___________________________________________________________________ |
| State: _________________________________ Zip Code: ______________________ |
| Home Phone: __________________________ Work Phone: ____________________ |
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E-Mail (required): ________________________________________________________ |
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Please tell us something about your interest in attending the training retreat: _______ _______________________________________________________________________ |
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Optional: Ethnicity: ____________________________________________________
Optional: Church/Organization: _____________________________________________
Can we list your name or church/organization in our publicity? ___________________ |
| Limited scholarships are available. For further information, please contact Elizabeth Leung at eleung@psr.edu |
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Accessibility needs: _______________________________________________________________ Dietary needs: ___________________________________________________________________ |
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Because a major goal of this retreat is community building, we strongly encourage all participants to stay overnight and join us for all meals. If you are NOT able to stay overnight and/or eat all meals with us at Mercy Center, please explain below:
(1) I will not be able to stay both nights because: _______________________________________________________________________
(2) I will not be eating all meals at Mercy Center because: _______________________________________________________________________ |
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REGISTRATION FEES (1) Early Bird (by Mar 20) = $100 (2) Regular (Mar 21-Apr 20) = $110 |
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