800-456-4197 FAX
510-897-6625
Healing Retreat -
November
27-28, 2010
Please list each name as you wish them
printed on name tags.
NAME________________________________________________________
ADDRESS____________________________________________________
CITY___________________________________STATE__ ZIP_________
PHONE_________________________EMAIL_______________________
DATE__________________
REGISTRATION FEES: (your canceled check
will be your receipt)
Cash_______Check_______Credit Card____
Advance : $45 2 days until
November
20 ................................ $__________
$35
1 day until November 20( ) Sat
( ) Sun.......$__________
At the Door:$55 / 2 days -
$35 / 1 day
I will pray one Rosary daily for the
success
of the Conference
(
)
Donation to help others
attend
$___________
Total Paid (Make checks payable to Saint Raphael Ministries) $___________
CHARGE: VISA MC
DISCOVER
AMEX
Card
No.__________________________________________________________
Exp.
Date________________
Signature_______________________________
You can FAX credit card Conference
registration
to - (510) 897-6625
or E-Mail: srm.inc@juno.com
Hotel Rooms Reservations: Good Nite -
Inn
- Single or Double $69.95 (650)589-7200
Holiday
Inn
(650)873-3550
LOCATION
:South San Francisco Conference Center located at
255 South Airport Blvd., in South San
Francisco.
The Center is about
10 minutes north of the San Francisco
International
Airport.
On US 101 North or South take the South
Airport Blvd exits.
For directions (650) 877 - 8787
Map
&
Directions