Registration for The 2007 National Meeting of the City Impact Roundtable

Registration for

The 2007 National Meeting of the City Impact Roundtable

El Paso, TX (Juarez, El Paso, Las Cruces region)

April 19-21, 2007

3 Ways to Register: (Please fill out a separate registration form for each individual attending.)

Fax: 760-200-8837 (if paying by credit card) or

Online: Pending

Mail: Attn: Dee Neely, Mission America, PO Box l3930, Palm Desert, CA 92255 (if paying by check or credit card. Make check payable to Mission America Coalition)

• Early-bird Registration $120 (before January 15)
• $135 January 16 - February 15
• Regular Registration $150 (January 16 – April 6)
• Late Registration $175 (April 7-19 )
• Single day registration: $70 Thursday with banquet, $50 without

$70 Friday

$50 Saturday

Please note: Full registration includes 3 meals but does not include lodging.

Register your lodging at Hilton El Paso Airport by Feb 2 for CIR rate of $75.00 - $83.00 per night. Hotel phone: 915-778-4241

http://www.hilton.com/en/hi/hotels/index.jhtml?moreDesc=true&ctyhocn=ELPHIHF

Title: _________ Name: ________________________________________________________

Ministry Name: _______________________________________________________________

Mailing Address: ______________________________________________________________

City: ______________________ _____________ State: ________ Zip Code: ______________

Phone: __________________________ Cell or other: _______________________________

Email: __________________________________________

Website: ________________________________________

____ I have enclosed my check payable to the Mission America Coalition $________ (amount)

OR

____ Please bill my credit card: ___ Visa ___ MasterCard ___ AmEx $____________(amount)

Card Number ________________________________________ Exp Date _________________

Signature Authorization _________________________________________________________

info@cityreaching.com * Phone: 952-224-3127 (9-noon Mon-Fri CST) * www.cityreaching.com