Registration for Peace and Justice Session
Return with $10.00 Registration Fee to
Diocese of Arlington
200 N. Glebe Rd., Suite 506
Arlington, VA 22203
 

Last Name:
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First Name: ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___

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Address: ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___

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City: ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___
State: ___ ___

Zip Code: ___ ___ ___ ___ ___
Telephone: ___ ___ ___ - ___ ___ ___- ___ ___ ___
Email Address: ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___

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Saturday, September 18, 2004 from 8:30 AM - 1:30 PM
at St. Charles, 3304 N. Washington Blvd., Arlington, VA