CCSA Western Conference 2011
Friday, October 28 - Sunday, October 30 St. Mark's College Vancouver, BC
Registration Deadline October 15, 2011
Include area code
Year of study
Program of study
Are you in need of accommodation for the conference?
Are you able to provide billeting for out of town participants?
How many people can you accommodate in your home?
more than 4
Emergency contact name
Emergency contact phone number
include area code
Medical Issues or Allergies
Notes, Comments, or Requests
i.e. Request to be billeted with a friend
Select t-shirt size
Select the method in which you plan to pay the $70 fee
I will mail a check to St. Mark's Campus Ministry prior to the conference date
My Campus Minister will forward the payment to St. Mark's
I will phone St. Mark's and pay via credit card
For more information, please contact: Maureen Wicken Coordinator of Campus Ministry and Continuing Education St. Mark's Catholic Campus Ministry at UBC 5935 Iona Drive Vancouver BC V6T 1J7 604-822-6862 ext 112 firstname.lastname@example.org
Never submit passwords through Google Forms.
Terms of Service