Paper - KNIGHTS OF COLUMBUS PENNSYLVANIA STATE COUNCIL CONVENTION APRIL 26 - 28, 2024

Registrations submitted in paper format.

* Indicates required field

Name *

First

Last

Member Number *

Council Number *

District Number *

Note: District Number is required for District Deputies.

Attending *

Yes No

Spouse Attending *

Yes No

Spouse Name *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Phone Number *

Email *

Turnpike Exit Number *

Turnpike Entrance Number *

Registrations Prior to April 1, 2024 *

Registration Amount *

Registration After April 1, 2024 *

Late Registration Amount *

Meal Plans *

Meal Plan Amount *

Banquet 75 *

Ladies Luncheon Tickets *

Child - Ladies Luncheon Tickets 25 *

Child Meal Plans - 125 *

Date Received *

Banquet Amount *

Ladies Luncheon Amount *

Child Ticket Amount *

Child Meal Plan Cost *

Check Number *

Amount Received *

Submit