The International Symbol of the Catholic Charismatic Renewal
 Under the patronage of Our Blessed Mother
Application form for Conference Organizers


Please take a few minutes to complete and submit this form.
Name of organization:
Street address:
City:
State / Province:
Postal Code:
Country:
Diocese:
Family name of contact person:
Given name of contact person:
Email Address:
Telephone number:
Event date:
Expected attendance:
Select option Expected attendance: A
B
C