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KNIGHTS OF COLUMBUS – LUZON JURISDICTION COUNCIL NO. ________ LOCATION: __________________________

DIST. NO. _______

TO: THE SECRETARIAT Knights of Columbus 9th National Convention Gen. Luna cor. Sta. Potenciana Streets Intramuros, Manila SUBJECT:

PRE-REGISTRATION – 9TH NATIONAL CONVENTION – APRIL 27, 28, & 29, 2012

Please reserve for the following pre-paid delegates from Council __________________ : Name

Nickname

Council/Position

Amount Paid

1. _______________________________

________

________________________

_______

2. _______________________________

________

________________________

_______

3. _______________________________

________

________________________

_______

4. _______________________________

________

________________________

_______

5. _______________________________

________

________________________

_______

6. _______________________________

________

________________________

_______

7. _______________________________

________

________________________

_______

8. _______________________________

________

________________________

_______

9. _______________________________

________

________________________

_______

10. _______________________________

________

________________________

_______

TOTAL

_______

Enclosed is cash amounting to thirty thousand (Php 30,000.00) pesos representing advance payment for the registration fees of above-mentioned delegates. Submitted by: _____________________________ Grand Knight (CY 2011-2012)

Date: _____________


9th National Convention Registration Form