2023 ADL Convocation

Online Options

Annual Dues ($150.00)
Freewill Donation ($0.00)

Registration Options

Single ($450.00)
Double ($350.00)
Name who you will rooming with if choosing a double.
Liaison and Spouse ($700.00)
Virtual ($25.00)

Name

Name of Room Mate/ Spouse

Address

Phone Number

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Allergies to Food

Emergency Contact/ Name and Phone

Travel Plans Arrival April 17th Airline Time Flight No.

Departure April 21 Airline Time

Any Special Needs

Freewill Donation Amount or Additional Gift Amount

(Arch)Diocese

Name of Liaison

Name of Assistant/Associate

Phone Number

Address

Running Total

$0.00

Total

$0.00

Billing Information

Secure checkout PCI compliant

Name

I am representing an organization

Credit CardSecure Payment

Address

Mobile Phone Number