EmailMe Form - 2020 CENTENNIAL CELEBRATION

WELCOME TO THE 2020 CENTENNIAL REGISTRATION, PLEASE READ THE FOLLOWING:

BE ADVISED, THE CENTENNIAL REGISTRATION IS THE ONLY REGISTRATION FOR 2020, THERE IS NO SPECIFIC REGISTRATION FOR THE PCEJ WORKERS' MEETING OR HOLY CONVOCATION. DELEGATE BENEFITS ARE HIGHLIGHTED BELOW.

IF YOU DO NOT WISH TO BECOME A CENTENNIAL DELEGATE AT THIS TIME, BUT DESIRE A HOTEL FOR THE 2020 PCEJ 100TH ANNUAL WORKERS' MEETING, PLEASE LEAVE THIS PAGE NOW AND CONTACT DEACON RICKY TAYLOR @ 267-218-3804 OR SISTER RUTH BURNETTE @ 717-805-2464, THEY WILL BE HAPPY TO ASSIST YOU WITH HOTEL RESERVATIONS.

IF YOU WANT TO BECOME A 2020 CENTENNIAL DELEGATE, PLEASE CONTINUE AND COMPLETE THE REQUIRED FIELDS.

ONCE YOU HAVE COMPLETED CHECKOUT AND PAYMENT, PLEASE KEEP YOUR CONFIRMATION AS YOU WILL NEED IT IN THE FUTURE.

THANK YOU FOR YOUR SUPPORT! *

I HAVE READ AND FULLY UNDERSTAND THE INSTRUCTIONS

Name *

First Last

Preferred Phone # *

### - ### - ####

Address *

Street Address City State / Province / Region Postal / Zip Code

Email *

CENTENNIAL REGISTRATION & SINGLE PAYMENT PLAN OPTIONS: For Payment Plans, you must complete this form for each installment. Please Select Payment Option.

PLEASE NOTE: THIS IS NOT THE PCEJ WORKERS MEETING OR CONVOCATION REGISTRATION *

1 PERSON - $100

2 PERSONS - $200

3 PERSONS - $300

4 PERSONS - $400

INSTALLMENT-$50

*Processing fees will be added at checkout. Processing fees are non-refundable.

PAYMENT INSTRUCTIONS:
- SELECT PAYMENT AMOUNT
- PLACE DELEGATE(S) NAME IN THE BOX BELOW

List the name(s) of the delegates including yourself *

Would you like to purchase additional Legacy Leaves? *

Yes, I would like to purchase additional Virtual Legacy Leaves.

No, I do not wish to purchase additional Virtual Legacy Leaves at this time.

If Yes, select amount, place the Honoree(s) name in the suggested box.

CENTENNIAL VIRTUAL LEGACY LEAF OPTIONS:

*Honor Someone On The PCEJ Centennial Virtual Legacy Tree*

List the name(s) of the Legacy Honoree:

Are you attending the 100th Annual Workers' Meeting? *

YES

NO

Will you need a hotel for the 100th Annual Workers' Meeting? *

YES

NO

*If you have special requests/needs with your hotel room, i.e. suites, handicap accessible room, ground floor, etc., please contact Deacon Ricky Taylor 267-218-3804 or Sister Ruth Burnette 717-805-2464 to assist with hotel reservations.

PLEASE NOTE, a Paypal Account is not necessary to checkout. To submit a payment, please proceed as a Paypal guest. *

I HAVE READ AND FULLY UNDERSTAND THE INSTRUCTIONS