KNIGHTS OF COLUMBUS – LUZON JURISDICTION COUNCIL NO. ________ LOCATION: __________________________ DIST. NO. _______ TO: THE SECRETARIAT Knights of Columbus 9 th National Convention Gen. Luna cor. Sta. Potenciana Streets Intramuros, 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)

9th National Convention Registration Form

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Advance registration form for Knights of Columbus 9th National Convention on April 27-29, 2012.

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Page 1: 9th National Convention Registration Form

KNIGHTS OF COLUMBUS – LUZON JURISDICTION

COUNCIL NO. ________ LOCATION: __________________________ DIST. NO. _______ TO: THE SECRETARIAT Knights of Columbus 9th National Convention Gen. Luna cor. Sta. Potenciana Streets Intramuros, Manila SUBJECT: PRE-REGISTRATION – 9TH 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)