Ontario State Office, Knights of Columbus State Convention Registration Form - SO-04 393 Rymal Road West, Suite 201 Hamilton, ON L9B 1V2 One registration per form only Tel:1-800-759-0959 Registration and event tickets for 116th State Convention - April 26 – 28, 2019

Council # District # Council Name:

Surname: First Name: Spouse Name:

Address: City: Postal Code:

Email: Phone:

Voting Delegates Registration MUST REGISTER BEFORE APRIL 10, 2019 First Delegate Mandatory Registration Fee $45.00 includes Second Delegate Convention Book, Name Tag and Souvenir Pin

Non-Voting Members Registration Council Chaplain District Deputy MUST REGISTER BEFORE APRIL 10, 2019 District Warden Member

Mandatory Registration Fee $45.00 includes General Agent Field Agent Convention Book, Name Tag and Souvenir Pin Master Squires 4th Degree

Event Ticket Order

Saturday 3 meal package (including State Banquet) $150 Qty Mandatory Ladies Breakfast and State Banquet $135 Qty Registration Fee $45 will Ladies Program (including lunch) $50 Qty be applied. State Banquet $95 Qty Chaplains Luncheon (Friday - everyone is invited) $40 Qty 4th Degree Exemplification Lunch (Sunday) $40 Qty Convention Golf Shirt $35 Qty Total Amount Due Convention T-shirt $20 Qty Souvenir Pin $2 Qty

NOTE: THERE WILL BE NO ON-SITE REGISTRATION AT THE CONVENTION. PRE-REGISTRATION ONLY. Cancellations received before APRIL 10, 2019 are subject to review. No refunds after APRIL 10, 2019. Full payment must be submitted with registration form. No guarantee of tickets for Ladies’ Lunch and / or State Banquet can be made without payment.

Make cheque payable to “K. OF C. CONVENTION 2019” FOR OFFICE USE ONLY Please mail completed form and payment before April 10, 2019 directly to: Cheque # Knights of Columbus Convention 2019 Amount 393 Rymal Rd West, Suite 201, Hamilton, ON L9B 1V2 Date DO NOT FAX Registration #