2**005 CFC Regional Workshops**

**Workshop and Hotel Registration Information\
*(For Your Record Purposes Only)***

When making your reservations, please refer to the meeting as the
CFC/OPM Workshop. This will help ensure conference rates and
availability. The hotels\' phone numbers and deadline dates are listed
below.  

Hotel reservations must be made separately from conference registration
and are the responsibility of each participant. **You must use the group
name (Community Health Charities/CFC) when making your reservation to
receive the discounted room rate.**

+---------------------------+---+-------------------+---------------------+
| Hotel/Workshop Dates      | H |                   | Workshop            |
|                           | o |                   | Registration        |
|                           | t |                   |                     |
|                           | e |                   |                     |
|                           | l |                   |                     |
|                           | R |                   |                     |
|                           | e |                   |                     |
|                           | g |                   |                     |
|                           | i |                   |                     |
|                           | s |                   |                     |
|                           | t |                   |                     |
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|                           | a |                   |                     |
|                           | t |                   |                     |
|                           | i |                   |                     |
|                           | o |                   |                     |
|                           | n |                   |                     |
|                           | \ |                   |                     |
|                           | D |                   |                     |
|                           | e |                   |                     |
|                           | a |                   |                     |
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|                           | l |                   |                     |
|                           | i |                   |                     |
|                           | n |                   |                     |
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|                           | n |                   |                     |
|                           | d |                   |                     |
|                           | R |                   |                     |
|                           | a |                   |                     |
|                           | t |                   |                     |
|                           | e |                   |                     |
|                           | s |                   |                     |
+---------------------------+---+-------------------+---------------------+
| **Miami, FL**             |   | February 14,2005  | Registration:       |
|                           |   |                   | \$200\*             |
| **March 13-16, 2005**     |   | \$138.00 -- Rate  |                     |
|                           |   |                   | Late Registration:  |
| Wyndham Miami Beach       |   | available March   | \$250\* (after      |
| Resort                    |   | 13-17 only.       | February 14, 2005)  |
|                           |   |                   |                     |
| 4833 Collins Avenue       |   |                   | \*Additional \$10   |
|                           |   |                   | Fee for Credit Card |
| Miami Beach, FL  33140    |   |                   | Reservations        |
|                           |   |                   |                     |
| 1-800-996-3426            |   |                   |                     |
|                           |   |                   |                     |
| <http://www.wyndham.c     |   |                   |                     |
| om/hotels/MIAMB/main.wnt> |   |                   |                     |
+---------------------------+---+-------------------+---------------------+
| **San Diego, CA**         |   | March 5, 2005     | Registration:       |
|                           |   |                   | \$200\*             |
| **April 6-9, 2005**       |   | \$120.00 -- Rate  |                     |
|                           |   |                   | Late Registration:  |
| Wyndham San Diego at      |   | available April   | \$250\* (after      |
| Emerald Plaza             |   | 4-10              | March 5, 2005)      |
|                           |   |                   |                     |
| 400 West Broadway         |   | only.             | \*Additional \$10   |
|                           |   |                   | Fee for Credit Card |
| San Diego, CA  92101      |   |                   | Reservations        |
|                           |   |                   |                     |
| 1-800-996-3426            |   |                   |                     |
|                           |   |                   |                     |
| <http://www.wyndham.c     |   |                   |                     |
| om/hotels/SANEP/main.wnt> |   |                   |                     |
+---------------------------+---+-------------------+---------------------+

Hotel Name
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Date reserved
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Confirmation Number
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Room Rate
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Save This Form for Check-in Reference Address questions or comments to
Herb Sanabria at 404-562-1393 or Linda Young at 703-528-1007.

![](media/image1.png){width="1.4625in" height="0.5833333333333334in"}

**NATIONAL *CFC* REGIONAL WORKSHOP Registration Form**

The registration fee for this year's workshop is \$200.00. A late
registration fee of \$250.00 per

person will apply for all those who register after 2/14/05 for Miami and
3/05/05 for San Diego.

Please submit one registration form for each registrant. Return form(s)
with credit card receipt or check, money order, or government voucher
made payable to ***CFC National Committee.*** Please include all
attendee names(s) on checks, money orders, government vouchers, or
credit card receipts. If the registration deadline has passed, please
call for space availability before making travel arrangements.

If using a government training voucher, please submit appropriate copies
with the registration forms for attendance verification and direct
payment from the sponsoring agency. The name and address of the person
to be billed **MUST** be provided and attached to registration form(s).

For additional information, please contact Herb Sanabria @ 404-562-1393
or Linda Young

@ 703-528-1007.

Name:
[\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}\_\_\_\_\_\_\_\_\_Organization[:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}

Mailing Address[:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}

Telephone \# [\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}
Fax#\_[\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}\_\_

E-MAIL:[\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}\_\_\_\_\_

CFC Name\_[\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}\_ CFC
Code[\_\_\_\_\_\_\_\_\_\_\_]{.underline}

Affiliation: [\_\_\_]{.underline}PCFO [\_\_\_]{.underline}LFCC
[\_\_\_]{.underline}Federation/Charity\_ [\_\_]{.underline}Volunteer
[\_\_]{.underline}Guest

Spouse/guest wishing to attend meal
functions\_[\_\_\_]{.underline}\$65.00

Will you attend the Sunday Workshop? [\_\_]{.underline}Yes
[\_\_]{.underline}No

Will you need special accommodations or meals? If so, please list:

**Select the workshop you will be attending**

Miami, FL \_\_March 13-16, 2005 San Diego, CA \_\_April 6- 9, 2005

Method of Payment: \_\_Check \_\_ Money Order \_\_ Government Voucher
\_\_ Credit Card

Make Checks, Money Orders, or Government Vouchers PAYABLE To: CFC
National CFC Committee

If using credit card, go to: [http://floridacfcworks.mollyguard.com or
http://sandiegocfc.mollyguard.com]()

Mail this Registration Form with your Check, Money Order, Government
Voucher, or Credit Card receipt to:

Herb Sanabria

PO BOX 2864

Atlanta, GA 30301

**Refunds Will NOT be made for cancellation requested one (1) week prior
to the Workshop**