Continuing Education Registration Form

UTC Course and Event Registration

2019-2020
I would like to register for the following Continuing Education event(s) at UTC: *

Fall 2019 Workshop: Pastoral Care with Children & Youth Fall 2019 Douglas J. Hall Colloquium (November 1-3, 2019)
I would like to participate in the following activities at the Colloquium: *

Alumni Lunch at UTC on the afternoon of November 1st Full Colloquium: November 1st - 3rd ($100 per ticket, UTC Alumni eligible for 50% discount) Day 1 of Colloquium: November 1st ($35 per one-day ticket, UTC Alumni eligible for 50% discount) Day 2 of Colloquium: November 2nd ($35 per one-day ticket, UTC Alumni eligible for 50% discount) Day 3 of Colloquium: November 3rd ($35 per one-day ticket, UTC Alumni eligible for 50% discount) Banquet at Circos Restaurant: November 2nd from 18:30-20:30 at Circos Restaurant ($50, to be paid on-site)
Participant Information
Full Name *

First Name Middle Name Last Name

Address *

E-mail *
Phone Number *

Area Code Phone Number
Special Needs of Participant
Please list any known allergies, diets, or medical conditions of which we should be aware above. Kindly be as specific as possible.
Should be Empty:

UTC Course and Event Registration