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There are several ways you may register for the Midwest Conference.
You can download the registration form in .pdf format HERE
and fax or mail the form to us.

You may also register online using the form below
if you want to receive an invoice and pay by check.

If you want to register online and provide a credit card
for payment, please use the link below to go to our
credit card processing center. This is an Archdiocese
of Louisville secure site.

2010 CONFERENCE ONLINE REGISTRATION FORM
(DO NOT HIT THE ENTER BUTTON UNTIL YOU HAVE COMPLETED THE FORM)

Registrant (if multiple registrants list contact first) Email Address

Registrant Email Address

   Registrant                                                                  Email Address

    CONTACT INFORMATION                                           BILLING INFORMATION

           Please send an invoice to address at left
   Archdiocese/Diocese                                                  Please charge the credit card below

Mailing Address Credit Card Type (VISA, MC, AMEX, DISCOVER)

City/State/Zip Card Number

Telephone Expiration Date Security Code (on back)

Fax Number Billing Address Zip Code

Email (if different than above) Name on card

PLEASE REVIEW ALL INFORMATION FOR ACCURACY BEFORE SENDING