Clergy Laity Assembly Registration 2023 - Deadline Bypass Form - The Greek Orthodox Metropolis of Chicago

CLA Registration 2023 - Past Deadline

Step 1 of 3

CONTACT INFORMATION

Name: Title(Required)

Name(Required)

Email(Required)

Cell Phone(Required)

Home Phone

Work Phone

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Parish(Required)

Parish Name(Required)

Parish City(Required)

Parish State(Required)

EVENT REGISTRATION

Type of Registrant(Required)

Proistamenos

Voting Delegate

Philoptochos

Observer (All Observers are Non-Voting)

Type of Voting Delegate(Required)

Metropolitan

Chancellor

Metropolis Council

VP Metropolis Philoptochos Board

Archdiocese Council Member (within the Metropolis)

Parish Council President (or representative)

Parish Delegate

Type of Philoptochos Registrant(Required)

Philoptochos Chapter President

Metropolis Philoptochos Board (Other than VP)

Philoptochos Chapter Member

Philoptochos Non-Voting Observer

Type of Observer(Required)

Archon

Presvytera

Retired Clergy/Retired Presvytera

Retreat Center Board Member

Metropolis Foundation Board Member

Metropolis Staff

Other Clergy

Other Observer

Observer Registration(Required)

(includes meals, events and conference materials)

Non-Voting Observer With Full Meals and Events $500

Grand Banquet only (Thursday evening) $100

Registration(Required)

(includes meals, events and conference materials)

Presvyteres and Retired Clergy $450

Grand Banquet only (Thursday evening) $100

Anticipated Date of Arrival(Required)

Anticipated Date of Departure(Required)

Will you be attending the Friday Evening Project Hope Philanthropy Project at St. Nectarios(Required)

Yes

Transportation(Required)

There is a possibility that transportation could be provided between the hotel and event spaces. If this opportunity is made available to you, would you use it?

Yes, I would use provided transportation if made available

No, I have my own means of transportation

Philoptochos Presidents Only: 2023 Delegate Information

The following persons will represent our chapter at the Clergy-Laity/Philoptochos Assembly as delegates (no more than 3).

Name of Delegate #1

First Last

Delegate #1 Email

Delegate #1 Phone

Delegate #1 Home Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Name of Delegate #2

First Last

Delegate #2 Email

Delegate #2 Phone

Delegate #2 Home Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Name of Delegate #3

First Last

Delegate #3 Email

Delegate #3 Phone

Delegate #3 Home Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Name of Philoptochos Non-Voting Observer

First Last

Philoptochos Observer Email

Philoptochos Observer Phone

Philoptochos Observer Home Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Would you like to add an additional Philoptochos Observer?(Required)

Yes

Name of Philoptochos Non-Voting Observer #2

First Last

Philoptochos Observer #2 Email

Philoptochos Observer #2 Phone

Philoptochos Observer #2 Home Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Would you like to add a 3rd Philoptochos Observer?(Required)

Yes

Name of Philoptochos Non-Voting Observer #3

First Last

Philoptochos Observer #3 Email

Philoptochos Observer #3 Phone

Philoptochos Observer #3 Home Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Chapter #(Required)

Chapter President Signature(Required)

Proistamenos Only: 2023 Parish Delegate Information

The following persons will represent our church at the Clergy-Laity Special Assembly as Delegates. Each Delegate must maintain a separate email address. Duplicate email addresses will be rejected.

Name of Parish Council President, VP or Parish Council Member:(Required)

First Last

Email for Parish Council President, VP or Parish Council Member:(Required)

Phone Number for Parish Council President, VP or Parish Council Member:(Required)

Home Address of Parish Council President, VP or Parish Council Member:(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Name of Parish Delegate #1:

First Last

Parish Delegate #1 Email

Parish Delegate #1 Phone Number

Parish Delegate #1 Home Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Name of Parish Delegate #2:

First Last

Parish Delegate #2 Email

Parish Delegate #2 Phone Number

Parish Delegate #2 Home Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Parish Email(Required)

Parish Phone Number(Required)

Proistamenos Signature(Required)

CONSENT/ACKNOWLEDGEMENTS

BILLING/PAYMENT

Processing Fee

Price: $0.00

Total

Coupon

Billing Name(Required)

First Last

Billing Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Credit Card(Required)

Card Details

Cardholder Name

Hidden

Fund Allocation(Required)

Clergy Laity Assembly

Comments

This field is for validation purposes and should be left unchanged.

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Clergy-Laity Assembly – Registration

CLA Registration 2023 - Past Deadline

CONTACT INFORMATION

EMERGENCY CONTACT

EVENT REGISTRATION

Philoptochos Presidents Only: 2023 Delegate Information

Proistamenos Only: 2023 Parish Delegate Information

CONSENT/ACKNOWLEDGEMENTS

BILLING/PAYMENT