REGISTRATION FORM

NOTE:  please print, fill out, and mail this form (address at bottom).  
Exact formatting is not important, as long as all the needed 
information is provided.  Please refer to the brochure or the 
information on the website, http://www.scn.org/wwfor/forseabeck07.html

Scholarship forms are also on the website, and further information, 
brochures and forms can be obtained by phoning 206-789-5565

ACROSS THE GENERATIONS:  THE CHALLENGE OF RECONCILIATION & THE FUN OF 
FELLOWSHIP

Fellowship of Reconciliation's 49th Annual Northwest Regional 
Conference

June 29 - July 2, 2007, Seabeck Conference Center, Seabeck, Washington

Please fill out name and gender for each person.  For more than 3 
people use a second form or the back of this one.  Please indicate age 
for each person under 18, and indicate up to 3 workshop choices in the 
boxes below for each person interested in participating in them, using 
the numbers from the brochure.  Workshop choices are not binding, but 
are intended to help the planning committee in scheduling.  Continue on 
back or separate paper for special requests.


1)_________________________    _____    _____    |____|  |____|  |____|
            (name)            (F or M)  (age)     up to 3 workshops


Dietary:  no red meat |_|  vegetarian |_|  vegan |_| 

For Sun evening:  salmon |_|  or  veg option |_|

Other dietary (such as allergies)  ___________________________________

Volunteer Jobs (more opportunities at Conf) 
______________________________



2)_________________________    _____    _____    |____|  |____|  |____|
            (name)            (F or M)  (age)     up to 3 workshops

Dietary:  no red meat |_|  vegetarian |_|  vegan |_| 

For Sun evening:  salmon |_|  or  veg option |_|

Other dietary (such as allergies)  ___________________________________

Volunteer Jobs (more opportunities at Conf) 
______________________________




3)_________________________    _____    _____    |____|  |____|  |____|
            (name)            (F or M)  (age)     up to 3 workshops


Dietary:  no red meat |_|  vegetarian |_|  vegan |_| 

For Sun evening:  salmon |_|  or  veg option |_|

Other dietary (such as allergies)  ___________________________________

Volunteer Jobs (more opportunities at Conf) 
______________________________



Cost includes 8 meals and 3 nights' lodging



Shared room with private bath (no single rooms)
______ number of people age 17+     @ $170 = ________
______ number of people age 12 - 16 @ $125 = ________
______ number of people age 3 - 11   @ $85 = ________
______ number of people age 0 - 2, free  



Single room, adults only, shared bath down the hall
______ number of people             @ $170 = ________


Inn or Reeser House - shared room, shared bath down the hall
______ number of people age 17+     @ $155 = ________
______ number of people age 12 - 16 @ $115 = ________
______ number of people age 3 - 11   @ $75 = ________
______ number of people age 0 - 2, free  



Pines, Maples - shared room, shared bath down the hall
______ number of people age 17+     @ $145 = ________
______ number of people age 12 - 16 @ $105 = ________
______ number of people age 3 - 11   @ $70 = ________
______ number of people age 0 - 2, free  



Other Houses - shared room, shared bath down the hall
______ number of people age 17+     @ $130 = ________
______ number of people age 12 - 16  @ $95 = ________
______ number of people age 3 - 11   @ $65 = ________
______ number of people age 0 - 2, free  



We will assume your party wants lodging together unless otherwise 
indicated.  If 2 adults indicate "couple," an effort will be made to 
assign them to their own room.

Day Use (all ages, no meals or lodging) 
______ people @$24 for full 3-day conference = _________



See http://www.seabeck.org for info on lodging options

SUBTOTAL =                                               
________________


Registration fee  -  
times the # of people 18 or older @$55 = ____________
($50 if received by May 25)

Donation to scholarship fund 
to help low income people attend conference         _______________

Donation to conference 
to keep registration fees low for everyone          ________________

TOTAL                                        _______________

Make checks payable to: FOR Seabeck Conference 2007
(Canadians:  Canadian money accepted as if U.S.)

Check appropriate boxes   

     Total is enclosed  |_|

     Scholarship of _____ granted, balance enclosed  |_|

     Payment of _____ enclosed, scholarship pending  |_|

     Other - please enclose note  |_|

Address:  Street Address, City, State/Province, Zip/Postal Code


_____________________________________________________________


______________________________________________________________


Phone - day (_________) ___________-____________

Phone - eve (_________) ___________-____________ (include area codes)

Email  _____________________________________________

If different members of your party have different addresses or phone 
numbers, please provide info on back.

Check the box if you don't want your phone number or email listed on 
the conference roster. |_| no tel #     |_|no email

Special needs, preferences, and other information:  (include special 
access needs, housing preferences such as double bed or twin beds, if 
you snore loudly, etc.)  -  please specify on the back of this form   
|_|

Carpooling:    I / We have space for ____  riders.      I / We ____ 
(number of people) need a ride.

Please return this form by May 25th to:  Jean Buskin, 9728 3rd Ave NW, 
Seattle  WA  98117  (USA)

After that time, phone 206-784-9988 or email bb369@scn.org to inquire 
about space.

PLEASE HELP US!  We must inform Seabeck Center of our attendance 
numbers by May 28, or face penalties.  Your registration by May 25 will 
allow us to plan.