2012 Called to Be Brothers Regional Assembly

Individual Information
Name * Title First Last Suffix
Community or Ministry Name *
Community or Ministry Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Please indicate your HOME District by checking the appropriate box below. *
District of Eastern North America Midwest District New Orleans-Santa Fe District San Francisco District Other
Email Address, if any
Best Contact Phone Number * ### - ### - ####
Alternate Phone Numbe ### - ### - ####
Resident Hall Information

Because this is the summer 2012 Regional Retreat, all participants will reside in the following on campus, air-conditioned resident halls:
Suite style Halls – 4/suite with private bedrooms and a shared bathroom
•Dorothy Day Hall
•Mother Teresa Hall
•North Hall
•Pope John Paul II Hall
Overflow housing (hall style) – private bedrooms with in-room sinks and vanities and shared “hall” bathroom.
•De La Salle Hall South
•De La Salle Hall North
Handicap accessible rooms will be provided upon request. Click Here to open the campus map (or open the campus map attachment).
Please check below if you live in the Brothers' Community at Lewis University and will not require housing arrangements.
Yes, I live at Lewis
Please list any special accommodations. If none, insert N/A. *
Do you require a handicap accessible room? *
Yes No
Do you have suitemate preferences? *
Yes No
If yes, please provide their name(s) below. Please be sure that you have communicated with the Brothers listed below, and that the same names appear on all registration forms.

Suitemate #1 Title First Last Suffix
Suitemate #2 Title First Last Suffix
Suitemate #3 Title First Last Suffix
Suitemate #4 Title First Last Suffix
Moving about campus

To allow for better planning, please check one of the following:
*
I anticipate needing to use the shuttle service to move about campus. I will not need the shuttle service.
Dietary restrictions and current health conditions.

In the spaces provided below, please list any dietary restrictions and/or current health conditions you have that may necessitate support. Please type N/A in the space below if you have no restrictions or conditions.
Dietary restrictions *
Health conditions or medical issues *
Travel Information

SHUTTLE SERVICE BETWEEN CHICAGO O'HARE AND MIDWAY AIRPORTS AND LEWIS UNIVERSITY.
Shuttle dates and times (Please arrange your travel accordingly):
• Sunday, July 15th schedule: Shuttle buses will leave each airport at 11am, 1pm & 3pm.
• Thursday, July 19th schedule: Shuttle buses will leave Lewis University for the airports at 1:30pm & 3:30pm.
Shuttle service will also be provided to and from Joliet Union Station for those traveling via Amtrak or Metra regional trains. Please check the appropriate box for your mode of transportation to and from Lewis University.
*
I will drive and will not require shuttle service. I will fly into O'Hare and will require shuttle service. I will fly into Midway and will require shuttle service. I will travel via Amtrak and will require shuttle service. I will travel via Metra regional trains and will require shuttle service. I live on campus at Lewis University and will not require transportation.
Early arrival or late departure

Meals and lodging will be available for those who arrive one day early or depart one day late. The cost is $83.00/day. Payment will be made to the Christian Brothers Conference.
Neither airport, train nor on-campus shuttle service will be availalbe for those who arrive early or depart late.
Please check the appropriate box below if you will arrive early or depart late.
If you have not yet made your travel arrangements, check the "unsure at this time" box and email Michele Beauboeuf at michele@cbconf.org once your travel is arranged. *
I will not arrive early or depart late. I will arrive on Saturday, July 14th. I will depart on Friday, July 20th. Unsure at this time
Arrival time: HH : MM : SS AM/PM
Departure time: HH : MM : SS AM/PM
Please enter any comments here.
Attire

The attire is business casual for most of the Assembly. Dress up blacks or suits are recommended for the closing banquet.
PLEASE PRINT OUT A COPY OF THIS FORM FOR YOUR RECORDS BEFORE YOU CLICK THE SUBMIT BUTTON.
Do Not Fill This Out

Wufoo

Individual Information

Resident Hall Information

Moving about campus

Dietary restrictions and current health conditions.

Travel Information

Early arrival or late departure

Attire

PLEASE PRINT OUT A COPY OF THIS FORM FOR YOUR RECORDS BEFORE YOU CLICK THE SUBMIT BUTTON.