Jain Digest 2002 07 Vol 21 No 03

Author(s): Federation of JAINA
Publisher: USA Federation of JAINA

Page 12

JULY 3-6, 2003
JAINISM: THE ART OF LIVING 12TH BIENNIAL JAINA CONVENTION
REGISTRATION FORM: Register online at www.jainaconvention.org
CINCINNATI, OHIO
STEP 1: CONTACT INFORMATION: This information must be completed in order to receive your registration confirmation. Address: Street Apt#
City
State/Province Postal Zip Code
Home Phone
Email
Country/Region
STEP 2: PRIMARY AND IMMEDIATE FAMILY MEMBERS: For all members including primary individual, please specify the activity Ipreferred and the Total Fees per person in the far right column. Date of birth is MANDATORY.
INDIVIDUAL
ALL YOUTH SERVICE REGISTRATION NETWORKING ACTIVITIES PROJECT TOTAL Sex Date of Birth
FEES
FORUM (Age 13-35) (Age 13-35) FEES Last Name First Name M/F MM/DD/YYYY from chart in Step 3 ($55/Person) ($45/Person) (FREE) ($/person)
Yes Yes
Yes Yes Yes
Yes Yes Yes
Yes Yes Yes
Yes Yes Yes
Yes Yes Yes
Yes Number of attendees requesting VEGAN food for all four days Day Care needed Yes No TOTAL
STEP 3: INDIVIDUAL REGISTRATION FEES: Please choose the correct fee amount from the chart below.
EARLY BIRD JAN 16" to APR 16 to JUN 16" to TOTAL REGISTRATION FEES JAN 15th APR 15th JUN 15 JUL 06
FROM STEP 2 CHILDREN (UP TO AGE 5) FREE FREE 1 FREE FREE
DONATION YOUTH (AGE 6 UP TO AGE 17) US $60.00 US $80.00 US $100.00 US $120.00
TOTAL AMOUNT (US $) ADULTS (AGE 18 & UP)
US $90.00 US $110.00 US $130.00 US $150.00 Cancellation charges based on
$50.00 or 25%
NO REFUND TOTAL FEES per person from STEP 2.
(whichever is higher) Postmark of registration form will determine applicable registration fees
Please make your check (US$) payable to: JAINA CONVENTION 2003. Mail registration form and check to:
JAINA CONVENTION 2003 PO BOX 778 MASON, OH 45040-0778
TOTAL AMOUNT ENCLOSED FROM STEP 3: $_ Charge my: Master Card | Visa | Discover Card #: LIUILILI LILILILI LILILILI LILILIL Name of Cardholder:
*CW Code:
LLL Signature:
Exp. Date: JU "CVV Code is the last three numbers on back of credit card.
EMAIL: registration@jainaconvention.org PHONE: 937-848-3228
STEP 4: SIGNATURE: Primary registrant must sign and date below. . On site registration begins at 12:30pm on Thursday, July 3, 2003. CASH, CHECKS and CREDIT CARDS will be accepted during onsite
registration. Most programs will be at the Cincinnati Convention Center. • Those members planning to attend the JNF activities must complete the attached JNF Registration Form and mail with Convention Registration Form.
Tickets for Service Project are FIRST COME, FIRST SERVE. Deadline for registering: April 30, 2003. Liability waivers must be signed at the convention center by all participants. Parent or legal guardian must sign liability waiver if participant is under 18 years of age.
Youth activities include Dinner Theater, Night Rhythms and Service Project. • Receipt of confirmed registration will be mailed or emailed to you. Registration payment receipt will be mailed by December 2003. • Registrant must bring confirmation letter and picture ID to registration desk to collect registration material. • Bounced checks will incur a $25.00 additional fee. All credit card transactions will be done online by Registration Committee.
ABSOLUTELY NO REFUNDS will be given after June 15, 2003 or at the Convention for registration charges.
ABSOLUTELY NO REFUNDS will be given for JNF and Youth activities • JAINA and the Jain Center of Cincinnati-Dayton are not responsible for loss, injury or damage of any kind to registrants and or guests. SIGNATURE OF PRIMARY REGISTRANT:
DATE:
Would you like to receive the monthly email concerning
Jinformation about the 2003 Convention and future conventions? Official Use Only: Post Mark Date: Amount: Check No: Registration ID: Updated DB: Checked By:
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