the 2014 national philoptochos biennial … info/convention 2014...n momt’i d...
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PLEASE TYPE OR PRINT
Delegate’s Name:
Parish Name: Parish Phone:
Metropolis: Chapter Number:
Parish Address:
Delegate’s Home Mailing Address:
City/State/Zip Code:
Home Phone: Office: Cell:
Delegate’s E-mail:
EMERGENCY CONTACT INFORMATION
Emergency Contact:
Home Phone: Cell Phone:
Special Medical Needs:
THE 2014 NATIONAL PHILOPTOCHOS BIENNIAL CONVENTION
Philadelphia, PA July 6–9 2014
Registration fee must accompany this application.The deadline for application is June 1, 2014. A refund,less $150.00, per person, will be granted upon writtenrequest, received by June 23, 2014.
R E G I S T R AT I O N A P P L I C AT I O N
REGISTRATION FEE
___ Chapter Delegate . . . . . . . . .$575.00___ Metropolis Board Delegate . .$575.00___ National Board Delegate . . . .$575.00___ Observer/Non-Delegate . . . .$625.00
MAIL COMPLETED APPLICATION, ALONG WITH YOUR REGISTRATION FEE BY JUNE 1, 2014 TO:NATIONAL PHILOPTOCHOS OFFICE, Attention: Convention Registration
126 East 37th Street, New York, NY 10016
PLEASE RETURN THIS REPLY WITH YOUR DONATION IN THE ENVELOPE PROVIDED.
EXP.DATECARD NO.
TOTAL AMOUNT CHARGED
$ . SIGNATURE___________________________________
PRINT NAME ON CARD_________________________________________________________________________________
ADDRESS_____________________________________CITY____________________________STATE_______ZIP_________
PHONE_____________________________________________ CELL_____________________________________________
E-MAILL ADDRESS______________________________________________________________________________________
I want to give my support to the Greek Orthodox Ladies Philoptochos Society, Inc. for the Philoptochos Center of Philanthropy.
❐ Please bill me in the amount of $___________________Monthly or $________________________Quarterly
❐ Online payment $_________________ website here ❐ __________________________________________
TAX-DEDUCTIBLE Donations may be charged via credit card, mailed via postal mail, or given online using PayPal.
❐ Enclosed is my check payable to the Greek Orthodox Ladies Philoptochos Society, Inc.❐ Charge my credit card:
EXP.DATECARD NO.
TOTAL AMOUNT CHARGED
$ . SIGNATURE___________________________________
PRINT NAME ON CARD_________________________________________________________________________________
ADDRESS_____________________________________CITY____________________________STATE_______ZIP_________
PHONE_____________________________________________ CELL_____________________________________________
E-MAILL ADDRESS______________________________________________________________________________________
❐ Enclosed is my check payable to the Greek Orthodox Ladies Philoptochos Society, Inc.❐ Charge my credit card:
METHOD OF PAYMENT: (Full payment must be received with this form).* TOTAL AMOUNT $________________
EXP.DATECARD NO.
TOTAL AMOUNT CHARGED
$ . SIGNATURE___________________________________
PRINT NAME ON CARD_________________________________________________________________________________
ADDRESS_____________________________________CITY____________________________STATE_______ZIP_________
PHONE_____________________________________________ CELL_____________________________________________
E-MAILL ADDRESS______________________________________________________________________________________
❐ Enclosed is my check payable to the Greek Orthodox Ladies Philoptochos Society, Inc.❐ Charge my credit card:
METHOD OF PAYMENT: (Full payment must be received with this form).* Total Amount $___________________
* PAYMENT DOES NOT GUARANTEE OFFICIAL PHILOPTOCHOS DELEGATE REGISTRATION. DELEGATE REGISTRATION WILL BE OFFICIALLY CERTIFIED BY THE NATIONAL PHILOPTOCHOS. REGISTRATIONS NOT CERTIFIED BY THE NATIONAL PHILOPTOCHOS WILL HAVE NON-DELEGATE STATUS.
EXP.DATECARD NO.
TOTAL AMOUNT CHARGED
$ . SIGNATURE___________________________________
PRINT NAME ON CARD_________________________________________________________________________________
ADDRESS_____________________________________CITY____________________________STATE_______ZIP_________
PHONE_____________________________________________ CELL_____________________________________________
E-MAILL ADDRESS______________________________________________________________________________________
❐ Enclosed is my check payable to the Greek Orthodox Ladies Philoptochos Society, Inc.❐ Charge my credit card:
METHOD OF PAYMENT: (Full payment must be received with this form).*
* PAYMENT DOES NOT GUARANTEE OFFICIAL PHILOPTOCHOS DELEGATE REGISTRATION. DELEGATE REGISTRATION WILL BE OFFICIALLY CERTIFIED BY THE NATIONAL PHILOPTOCHOS. REGISTRATIONS NOT CERTIFIED BY THE NATIONAL PHILOPTOCHOS WILL HAVE NON-DELEGATE STATUS.
2014 NATIONAL PHILOPTOCHOS BIENNIAL CONVENTION, PHILADELPHIA, PADELEGATE PROFILE
Convention 2014 will be an experience of learning and sharing so that each delegate returns to her Chapterand Metropolis better informed, armed with skill sets to be successful in her responsibilities and inspired toshare the message of Philanthropy.
The Program Committee seeks to engage Philoptochos Presidents, members and stewards in every mannerpossible prior to and throughout the Convention.
Please respond to the survey below to help us broaden the team who will make a difference and create aConvention to remember. Check areas of interest and offer additional information. We need yourinput, expertise and participation!
SURVEYJOIN OTHERS TO OFFER SMALL GROUP SESSION BY SHARING YOUR ‘BEST PRACTICES’ AND KNOWLEDGE
� Experience/information on successfully increasing membership
� Successful philanthropic activity
� Leadership Skills
� Running a Successful Meeting
� Mentoring members for future Leadership
� Leadership Speed Networking
� Other ______________________________________________________________________
MEET AND GREET WITH OTHER CHAPTER PRESIDENTS/MEMBERS
� Informal sharing discussions
� Mentor and buddy with new delegate
� Adopt a new Chapter President
� Work with seasoned Chapter President to gain knowledge/skills
� Other ______________________________________________________________________
PARTICIPATE PRIOR TO CONVENTION
� Convention Program Input: Email/Conference Call
� Convention Program Webinars
� Contact Chapter/s to encourage Convention participation
� Convene Convention Chapter/Metropolis Meeting for Convention Discussion
� Speak about Convention to Chapter/Metropolis Meeting
� Other _____________________________________________________________________
MY PROFILENAME: ______________________________________________________________________________
EMAIL/PHONE: _________________________________________________________________________
PARISH NAME/LOCATION:_________________________________________________________________
METROPOLIS: __________________________________________________________________________PRIMARY AREAS OF EXPERTISE: ______________________________________________________________PRIMARY AREAS OF INTEREST:_______________________________________________________________
MY GOAL FOR CONVENTION: ______________________________________________________________HOW I WOULD LIKE TO HELP:_______________________________________________________________
CONTACT PROGRAM CHAIRMEN: Christine [email protected] Mekras Scurtis ____305.586.1928 [email protected]