Saturday, January 29, 2011

							                                  Saturday, January 29, 2011
                               City of Camden, New Jersey

                                                 Conference Co-Founders and Organizers
                                                   Beatrice M. Caraballo (856) 577-6661
                                                        Juan J. González (609) 230-0805


                              CONFERENCE REGISTRATION FORM
Please return this form by mail to:   Parada San Juan Bautista, Inc.
                                      P.O. Box 2908
                                      Camden, New Jersey 08101

Fax to:                               (856) 757-9633


Name:

Title:

Organization:

Address:

Address:

City, State, Zip Code:

Telephone #

Alternate Telephone #

Fax #

Email address:

Date of Parade:
         To be included in our National Directory of Festivals & Parades this date is very important.

Are you planning to arrive the day prior to the conference?              Yes              No