________________
JULY 3-6, 2003
Home Phone
STEP 1: CONTACT INFORMATION: This information must be completed in order to receive your registration confirmation. Address: Street/ Apt# State/Province Postal Zip Code
City
Last Name
First Name
JAINISM: THE ART OF LIVING 12TH BIENNIAL JAINA CONVENTION
Fax
JAINA CONVENTION 2003
PO BOX 778
MASON, OH 45040-0778
STEP 2: PRIMARY AND IMMEDIATE FAMILY MEMBERS: For all members including primary individual, please specify the activity preferred and the Total Fees per person in the far right column. Date of birth is MANDATORY.
INDIVIDUAL REGISTRATION Date of Birth FEES MM/DD/YYYY from chart in Step 3
JAIN NETWORKING FORUM ($55/Person)
SERVICE PROJECT (Age 13-35) (FREE)
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
☐Yes ☐Yes Yes Day Care needed Yes No TOTAL
REGISTRATION FORM:
Register online at www.jainaconvention.org
Sex M/F
Please make your check (US$) payable to: JAINA CONVENTION 2003. Mail registration form and check to:
EMAIL: registration@jainaconvention.org PHONE: 937-848-3228
Jain Education International
Number of attendees requesting VEGAN food for all four days
APR 16 to JUN 15th
JUN 16th to JUL 06th
STEP 3: INDIVIDUAL REGISTRATION FEES: Please choose the correct fee amount from the chart below. EARLY BIRD JAN 16th to JAN 15th FREE US $60.00 US $90.00
CHILDREN (UP TO AGE 5) YOUTH (AGE 6 UP TO AGE 17)
APR 15th FREE FREE FREE US $80.00 US $100.00 US $120.00 ADULTS (AGE 18 & UP) 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
Email
CINCINNATI, OHIO
Country/Region
Post Mark Date: Amount:
ALL YOUTH ACTIVITIES (Age 13-35) ($45/Person)
Yes
☐Yes
STEP 4: SIGNATURE: Primary registrant must sign and date below.
• On site registration begins at 12:30pm on Thursday, July 3rd, 2003. CASH, CHECKS and CREDIT CARDS will be accepted during onsite registration. Most programs will be at the Cincinnati Convention Center.
Check No:
TOTAL REGISTRATION FEES FROM STEP 2 DONATION TOTAL AMOUNT (US $)
TOTAL AMOUNT ENCLOSED FROM STEP 3: Charge my: Master Card Visa Card #: டடILILIL
Discover
▬▬▬▬▬▬||__ *CVV Code:L
Name of Cardholder:
Signature:
Exp. Date:
*CVV Code is the last three numbers on back of credit card.
• Those members planning to attend the JNF activities must complete the attached JNF Registration Form and mail with Convention Registration Form. • Tickets for Service Project are FIRST COME, FIRST SERVE. Deadline for registering: April 30th, 2003. Liability waivers must be signed at the convention center by all participants. Parent or legal guardian must sign liability waiver if participant is under 18 years of age.
• Youth activities include Dinner Theater, Night Rhythms and Service Project.
For Private & Personal Use Only
TOTAL FEES ($/person)
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 information about the 2003 Convention and future conventions? Registration ID: Updated DB: Checked By:
Official Use Only:
JAIN DIGEST. WINTER 2002/11 www.jainelibrary.org
