1. HOUSING & TRANSPORTATION
CCI USA 2008 REGISTRATION FORM
April 22 – 27, 2007
SEND REGISTRATION FORM AND DEPOSIT PAYABLE TO CCI-USA ($US only)
TO: Bonnie Cameron PO Box 525 Vernon CT USA (Tel: , E-M:
Name :
Address :
Telephone :
address :
*** I ___ DO ___ DO NOT want my contact information shared with the community
I plan to bring my children who are ages :
Fundamentals Teacher & Year :
___ This is my first CCI-USA workshop
I am a ____ Male ____ Female
I do NOT eat ____ Fish ____ Dairy ____ Red Meat ____ Poultry
____ Other (Please provide additional information on the back of this form)
I AM ____ Vegan (no egg, no dairy)
HOUSING & TRANSPORTATION
____ I need a ride to the workshop
____ I need a place to stay ** BEFORE the workshop
** Individuals are responsible for arranging their own lodging and travel for AFTER CCI. Space will be provided during the workshop to make arrangements.
Please use this space to provide information about housing or transportation needs :
Please indicate here any mobility problems :
____ I can provide housing for ____ people
____ I can provide a ride for ____ people
Housing at the Workshop
____ No roommate preference; please assign me a roommate
____ with other men ____ with other women ____ no gender preference
____ I would like to room with _________________________________ (Please consult to make sure your forms agree)
____ I don’t know who I’d like to room with, but I’ll let you know by March 15th
____ I need a family room for ____ adults and ____ children
____ I am a noisy sleeper
____ I am a light sleeper
There will be only limited options to negotiate any room switches
REGISTRATION
___ $ *Single Occupancy ___ $ *Double Occupancy ___ $ *Multiple Occupancy
___ No Charge [ Child under 4 years ] ___ ½ Adult rate [ Child 5 – 12 years ] ___ Adult Rate [ Child 13 and older ]
* EARLY BIRD REGISTRATION > subtract $ 25 if deposit received by
Do you have a scheduling conflict? Contact Michelle Gornish at for registration options.
I need $ ________ from the Bursary Fund in order to attend CCI-USA 2008 (Request must be received by )
Please indicate: $ ________ Deposit (50% of total workshop fee requested)
> If less than 50%, Payment Plan is required
$ ________ Donation towards Bursary Fund
$ ________ Donation towards general workshop fund
Enclosed is my check for $ ________ { $ 50 non-refundable processing fee for cancellations after April 11, 2008 }
Please outline your payment plan here (use reverse side, if needed):