22nd NPG Registration Form

Information: * Red box are Required Fields

NPG Regitration No

First Name

Last Name

Phone Number

Spouse First Name

Spouse Last Name

Spouse Email

Spouse Phone Number

Address

City

Zip Code

Total No of Adults ($110.00)

Total No of Youth (13 to 18) ($50.00)

Total No of Children (6 to 12) ($30.00)

Total No of Children Under 6 (Free)

Additional Adults Not Listed Above:

List Name of Children (6 to 12)

List Name of Youths (13 to 18)

List Name of Children Under 6

Travel Information and Accommodation:

Arrival Flight Number

Arrival Date

Arrival Time

Depart Flight Number

Departure Date

Departure Time

Total Amount Due

Payment Instructions

NorCal Members Only

Paying by Check

1. Make Check payable to “FCJC NorCal” and mail check at 357 McCall Drive Benicia, CA 94510.

Paying by Zelle

2. Zelle is fcjcnorcalcouncil@gmail.com please indicate that it is for “Your Area + NPG Registration”.

For Other Areas

Please submit your Registration payment to your Local Area NPG Coordinator or Household Servant Leader.

For Local Area Coordinator ONLY:

When remitting the registration fees for your Area to NorCal; Zelle or Check is the preferred payment method. Please make checks payable to "FCJC NorCal". If paying by Zelle please make sure to indicate it is for NPG registration payment.

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Families in Christ Jesus Community

22nd NPG Registration Form

Information: * Red box are Required Fields

Travel Information and Accommodation:

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