PARCCC & NBCCC Registration Form

(Print or type information)

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Last Name, Title (Fr. Dn. Br. Sm. Bp.) First Name
Email address: @.
Street Address City St Zip
Day Phone: Night Phone:

Registration for Techny Towers Conference, Room and Meals
Deadline for registration is August 16.

Please find enclosed a check for $ made out to PARCCC for
Registration Only ($75; Students $50. Add $30 if after Aug. 16; Students add $15)
Meal Packet Only ($35)
I will be staying off campus at
Full Registration, a single room (Dormitory bathroom) and Meal Plan Package ($190)
Full Registration, a double room (Dormitory bathroom) and Meal Plan Package ($160)
Student Registration, a single room (Dormitory bathroom) and Meal Plan Package ($165)
Student Registration, a double room (Dormitory bathroom) and Meal Plan Package ($135)
Transportation to Congress IX in Chicago after PARCCC ($20)

Background for Conference Participation

1. Are you a priest, deacon, brother or seminarian in good standing with your bishop or religious community?
Yes No . If no, please explain on the reverse side of this form.

2. What arch/diocese or religious community are you attached? (This will appear on your name tag.)

3. What is your nationality? (USA, Nigeria, Brazil, Haiti, India, Indonesia, etc)

4. How many years of ordination (priests, deacons, bishops) or religious profession (brothers) are you celebrating this year?

Registrations must be accompanied by check. Make all checks out to: PARCCC.
 Mail checks to:
Fr. Victor Cohea, Pres. PARCCC
2203 Second Street New Orleans, LA 70113
Phone 1-504-895-9020  Fax 1-504-899-0434  Alt. Phone 1-504-895-7749.