2021 Fall Pacific Central Chapter -UUMA Gathering Registration --- Tuesday, October 5 - Thursday, October 7
Friends:

It's time to plan for our 2021 PCD Chapter - UUMA Minister's Collegial Gathering. Registration for the gathering is now open. Early registration is encouraged! (Registration deadline is September 12.)

Our Gathering begins Tuesday, October 5 , at 2 p.m. and concludes on Thursday, October 7, with lunch. The location is Villa Maria del Mar, 21918 East Cliff Drive, Santa Cruz, CA 95062.  This is our first time having a gathering at Villa Maria del Mar - we are excited to experience this beach adjacent beauty on the Monterey Bay.  Please bring your fresh eyes to how we can use this new place to bring new attention to Hospitality and Accessibility for all in our chapter.

At this time, we are offering only single rooms for 30 attendees. If the cost of a single room presents a financial hardship, the difference in price between the single and double room will be made up for by the chapter. If we are able to offer double rooms at a later date, we can arrange for room-sharing.

The Registration Fees for the Retreat are:
     $470 Single Room
     $400 Single Room with Financial Assistance  
     $195 Commuter  (2 days, 6 meals)

At this time, we cannot accomodate part-time commuters. A $25 late fee is added for registrations after September 12th.  Rooms are not guaranteed until confirmed by the Registrar.

Scholarship Deadline: Sunday, September 12.
A limited number of scholarships of up to $100 per registrant are available (In addition to the funds offered for making up the difference between single and double room costs). If you need a scholarship, fill out the section at the bottom of the registration from.  Please do not pay your registration until you have received confirmation from the treasurer.  You may contact her at treasurer.uuma.pcd@gmail.com

Chapter dues are now optional to encourage maximum participation in our gatherings; however, we encourage those who can pay dues to do so, as these funds support the work of the Chapter. Please contact the Treasurer at treasurer.uuma.pcd@gmail.com if you are unsure if you have paid your UUMA Chapter dues.

Payment Information is repeated after you submit this form.
Make checks payable to PCD UUMA and mail to:
     Rev. Alyson Jacks
     325 Banks Street
     San Francisco, CA  94110

You can also pay via PayPal. Visit the PCD UUMA website (www.pcduuma.com) and click on the "Gathering" tab.

Please be sure to submit your registration information, by clicking on the blue "SUBMIT" button at the bottom of this page, before making your payment.

You will receive a confirmation email if your registration submission was successful.

All the best,

Bonnie Dlott
Fall Retreat Registrar

bdlott@comcast.net
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电子邮件地址 *
First Name *
Last Name *
Phone where you can be most easily reached *
Institutional Affiliation *
Please share your pronouns (e.g. she/her/hers, he/him, his, they/them/theirs/ or something else.) *
New or Returning Ministers, let us know a bit about you (check all that apply).
Chapter Dues 2021-22 (At our 2020 Retreat, we approved a motion  to make dues optional.)
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Registration Fee
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Arrival & Departure (optional)
If you are attending only a portion of the gathering, please indicate your arrival and departure times. (This allows us to provide an accurate meal count.)  
Roommate Request (if it becomes possible)
Scholarships Fund Contribution (optional)
If you would like to make a contribution for our Scholarship Fund, please enter the amount below, and add to your check.  
Staff Gratuity (optional)
Registration includes a 5% contribution to staff gratuity.  If you would like to make an additional contribution, please enter the amount below, and add to your check.
GRAND TOTAL (Payment must include registration and chapter dues. If you've made a scholarship donation or additional gratuity, please add this to your total.) *
Dietary Information *
必填
Specific food allergies and sensitivities?
Accessibility needs?
Scholarship Request
A limited number of scholarships are available (up to $100.00) and are awarded on a first-come, first-served basis. Additional amounts may be available in extraordinary circumstances.  Contact the treasurer with requests. The scholarship deadline is September 12th. Please check the reason that best describes your request.  For those needing a scholarship:  If paying by the PayPal/credit card option on our Chapter website, please pay the full amount and the Treasurer will send you a check for the scholarship.  If paying by check or bank transfer, please reduce your total amount by the scholarship requested, not to exceed $100.  If there are any concerns the Treasurer will contact you.
Scholarship Amount
Please indicate the amount of your request (not to exceed $100.00)
Long Distance Travel Assistance (requests are reviewed by treasurer)
This includes flight travel, bus, train or car rental (assuming there is no one you can share a ride with to the retreat)
Comments/Questions
Please enter in the box below or, for urgent needs relating to registration only, please email bdlott@comcast.net
Payment Instructions
PLEASE COMPLETE THIS REGISTRATION FORM BY CLICKING ON THE BLUE "SUBMIT" BUTTON BELOW, AND THEN MAKE YOUR PAYMENT EITHER BY CHECK OR PAYPAL. This information is provided again after you submit.

Make checks payable to PCD UUMA and mail to:
     Rev. Alyson Jacks
     325 Banks Street
     San Francisco, CA  94110

To pay via PayPal, please visit http://www.pcduuma.com/gatherings.html

Late registration deadline is September 12th. If accommodated, late registrations will require an additional $25 fee.
 
Please note:  After the registration deadline no refunds will be available unless there are people on the waiting list. 

For those needing a scholarship:  Please read the information under Scholarship Requests.
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