Midwest Asian-Pacific Young Adults Catholic Conference

Loyola University of Chicago, Lake Shore Campus, 6525 Sheridan Rd, Chicago, Illinois
July 31– August 2, 2009 (Friday 3 PM to Sunday Noon)

“Scions of the Proud: Passing the Flame of Hope for a Brighter Future”
A Program of the Midwest Asian-Pacific Institute for Mission and Ministry in the U. S. Catholic Church

REGISTRATION FORM
Please complete one form per person
PRINT First Name: Print Last Name: Date: Age:
(Mark one)
Position/Title: Circle one: Rev., Deacon, Student: (Mark) Yes  No  Phone: <18 
Bro., Mr., Mrs., Ms., Sister Under grad  Post grad 
19-25 
Address: City: State: Zip:
26-39 
>39 
Parish: Diocese: Ethnic background (Optional for future planning):

Email: Emergency contact:

Phone:

SATURDAY SESSIONS
MORNING BREAKOUT SESSIONS AFTERNOON BREAKOUT SESSION
Topics
Circle ONE in each box 1:30 PM Asian-Pacific Cultural Gathering, Dialogue & Sharing
I Inter-generational Select a community: Write in the box (1) 1st choice (2) 2nd choice
Dialogue 10:00 AM 11:00 AM
II Being Asian-Pacific
 Burmese  Cambodian  Chinese  Filipino
(1st I II III I II III  Guamanian  Hmong  Indian  Korean
& American Choice)

III Being Roman Catholic (2nd I II III I II III

 Indonesian  Japanese  Pakistani  Lao
Today Choice)  Samoan  Singaporian  Sri Lankan  Thai
 Tongan  Vietnamese
REGISTRATION PAYMENT
Make Check or Money Order payable to: Early registration On or After Amount
By: June 30, 2009 July 1, 2009 Due
Office For Asian Catholics
Memo: MWAPYACC Registration Fee  $110  $135 $
Includes Saturday Concert & meals-(Friday dinner,
Fill out Form and mail to:
Saturday breakfast, lunch, dinner, Sunday breakfast) TOTAL PAYMENT ENCLOSED $
Archdiocese of Chicago
REGISTRATION MUST BE RECEIVED BY JULY 10, 2009
Office For Asian Catholics PAYMENT MUST ACCOMPANY REGISTRATION
Cardinal Meyer Center REFUND INFORMATION
3525 S. Lake Park Avenue Written cancellation request must be received by July 10, 2009 to get refund of total amount less $30.00 for
Chicago, Illinois 60653 processing fee. NO REFUND FOR CANCELLATION REQUEST RECEIVED AFTER JULY 15, 2009

For more information please visit the conference website: midwest-apyacc.org

Registration contacts:
SPECIAL NEEDS (Please specify): SINGERS NEEDED FOR LITURGY
Please indicate your interest: Malou Kizer (773) 478-6152 maloukizer@hotmail.com
Disability:______________________  Yes  No Kou Ly (651) 329-6933 tkouly@gmail.com
(Practice time & place to be announced) Teresita L. Nuval (312) 534-8328 tnuval@msn.com or
Other: ________________________ tnuval@archchicago.org

Tour of Chicago (Optional Sunday afternoon). Accommodations: Make own reservation directly with Loyola University
By reservation only with separate registration. Contact Amanda Hitterman Phone: 773-508-8067 or email: ahitter@luc.edu
For cost and details, visit website or see registration brochure. Room rates per night plus tax: $60 single $45 double (Rates effective dates: July 29–August 4, 2009)
Indicate interest: Yes  No 
FOR OFFICE
USE Date rec’d Check # Amount $ Entered By:
MDK 1/31/09