SEJ Cabinet Consultation 2018 - COMMUTERS
January 23 - 26, 2018


EPWORTH BY THE SEA
Your Name       Male   Female
Name of Spouse 
Address 
City  
State      Zip Code    
Roommate if other than spouse 
Phone         Email    
Position / Title 
Annual Conference 

Please check applicable rate - Full payment due by January 2, 2018
  $150.00 - Single           $225.00 - Couple
BANQUET ENTREE SELECTION:
Beef:     Chicken:     Vegetarian:
Epworth Cancellation Policy: Any cancellation after January 2, 2018 will forfeit the registration fee.
Make check payable to Epworth By The Sea.
Check #    Amount: $   
OR
Charge to:    Visa      MasterCard       Discover      Amount to Charge: $
Card Number:        Expiration Date:
3 Digit Security Code:       Zip Code of Billing Address:
Name on Card:       
 Check here to affirm that I am authorized to make these credit card charges
 I am registering for CEU credit
Please submit this form online, print to Tiffany Flavell & FAX to 912-634-0642, or mail to:
Epworth By The Sea
ATTN: Tiffany Flavell
P. O. Box 20407
St. Simons Island, GA 31522
No phone reservations accepted. No pets or alcohol. Check in: 4:00 p.m. - Check out 11:30 a.m.
* CONFIRMATION OF YOUR RESERVATION WILL BE SENT TO YOU *
This form is for Epworth By The Sea ONLY.