Annual  Meeting  2015  Registration  Form  Sign up early and save! Early registrations with payment must be postmarked

or in our Seattle Conference office by April 3, 2015

First time attendee? Please check box Name: _____________________________________________________ q Yes Address: _________________________________________________________________ City/State/Zip: _____________________________________________________________ Daytime phone: (____________)______________________________________________ Email: ___________________________________________________________________ (The Annual Report Booklet will be e-mailed to you and posted online.) Local Church: ______________________________________________________________

q If you are under 18, please indicate adult chaperone Name: ___________________________ email: _________________________________

 Early  Registration  on  or  before  April  3rd # Adults, High School Youth, Young Adults (18-35 years) ...................................... $83.00 x ____ = ____________ Retired Clergy & spouses, PNC Members in Discernment and Middle School .... $63.00 x ____ = ____________ (Children 8 years old and under are free except for meals)

Late  Registration  after  April  3rd   # Adults, High School Youth, Young Adults (18-35 years) ................................. $103.00 x ____ = _____________ Retired Clergy & spouses, PNC Members in Discernment & Middle School ..... $83.00 x ____ = _____________

Meals Please write in the total cost from second page. ............................................................... $_______________

Please note: No meal orders are possible after April 13th.

Total  Enclosed ........................................................................................................................................................ $ ______________  

Please make checks payable to PNC-UCC and mail to 325 N 125th Street, Seattle, WA 98133.

(Please  see  meal  options  on  second  page)  

 Meals      Please  note:    All  meal  orders  must  be  in  the  Conference  office  by  April  13th.    It  is  not  possible  to  add  or  change  your  meals  after  this  date.    Totals  include  tax  and  gratuity.    Please  write  in  the  number  for  each  meal  choice.    All  meals  include  tax  and  gratuity.    Friday  dinner    Chopped  hearts  of  romaine  and  head  lettuce,  diced  tomatoes,  sliced  olives,  red  radishes,  julienne  carrots,  diced  cucumbers,  sunflower  seeds  and  feta  cheese  with  huckleberry  vinaigrette.  Grilled  Chicken  Breast  with  brandy  Dijon  sauce  and  fresh  chives  with  rice  pilaf.  French  Apple  Torte  with  caramel  sauce  and  whipped  cream.  Coffee,  water,  or  tea  by  request.     Chicken  #__________          Veg.  option  #___________  x  $32.00  ea.  =  _____________      Saturday  Box  Lunch  Gourmet  grilled  turkey  with  pesto  wrap  or  grilled  vegetable  wrap.    Both  with  chips,  cookie,  soda  or  water.                                                                                                                Turkey    Wrap#_________        Veg,  Wrap  #  ________  x  $15.00  ea.  =  _____________    

     Saturday  dinner    (buffet)  Baked  Alaskan  Halibut  with  Parmesan  cheese  and  basil  and  Broiled  Tri-­‐Tip  Steak  with  sauce  demi-­‐glace,  Green  Bluff  Salad,  Blue  Cheese  Bowtie  Pasta  Salad,  Roasted  Red  Potatoes,  Vegetable  Medley  New  York  Cheesecake  or  Chocolate  Flourless  Cake.  Coffee,  water,  or  tea  by  request.    A  plated  Vegetarian  Option  is  available  or  you  may  choose  the  buffet  instead.       Buffet    #_________  x  $35.00  ea.  =  _____________       Plated    Veg.  option  #  _________  x  $35.00  ea.  =  _____________      

   Total  (please  transfer  to  first  page)    ..........................................................................  $  _________________