Healing the Wounds of Racism
Register Early
Maximum Enrollment is 32
Registration Form
Please Check one:
    • Feb.28, Mar.14, 28
    • February 15-17, 2009
    • August 21-23, 2009
    • August 24-26, 2009
    • September 18-20, 2009
    • October23-25, 2009

Name__________________________________________________________________

Address_______________________________________________________________

City, State____________________________________________ZIP____________

Phone (daytime)_____________________Phone(evening)____________________

Email_________________________________________________________________

Church________________________________________________________________

I would like a certificate for Continuing Education Credit: __Yes __No

REGISTRATION FEE:  $200

Amount Enclosed: $________________________

Make checks payable to:
Eastern Pennsylvania Conference (Memo: HWOR) Mail this registration form to: Attn: Rev. Hilda Campbell EPAUMC P.O. Box 820 Valley Forge, PA 19482-0820 SPECIAL NEEDS: Every effort will be made to accomodate dietary or other special needs listed below. Please be specific. ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ For further information, see http://www.ppjr.org/ltrain, or contact Rev. Hilda Campbell, hilda.campbell@epaumc.org, 610-666-9090, ext 224, or Warren Tyson, warrent@easterndistrict.org, 215-723-5513, ext. 138.