9th National KC Convention Registration Form

KNIGHTS OF COLUMBUS – LUZON JURISDICTION

COUNCIL NO. ________ LOCATION: __________________________ DIST. NO. _______

TO: THE SECRETARIATKnights of Columbus 9th National ConventionGen. Luna cor. Sta. Potenciana StreetsIntramuros, Manila

SUBJECT: PRE-REGISTRATION – 9 TH NATIONAL CONVENTION – APRIL 27, 28, & 29, 2012

Please reserve for the following pre-paid delegates from Council __________________ :

Name Nickname Council/Position Amount Paid

1. _______________________________ ________ ________________________ _______

2. _______________________________ ________ ________________________ _______

3. _______________________________ ________ ________________________ _______

4. _______________________________ ________ ________________________ _______

5. _______________________________ ________ ________________________ _______

6. _______________________________ ________ ________________________ _______

7. _______________________________ ________ ________________________ _______

8. _______________________________ ________ ________________________ _______

9. _______________________________ ________ ________________________ _______

10. _______________________________ ________ ________________________ _______

TOTAL _______

Enclosed is cash amounting to thirty thousand (Php 30,000.00) pesos representing advance payment for the registration fees of above-mentioned delegates.

Submitted by: _____________________________ Date: _____________Grand Knight (CY 2011-2012)