Ecumenical Dialogue Day
Registration Form
 Wednesday, May 24, 2006
(Kindly PRINT information)

Name _______________________________________________

Religious Tradition _____________________________________

Parish/Institution _____________________________________

Address ______________________________________________________

Phone Number _____________________________________  

E-mail address _____________________________________  

Menu Choices:  (Please check one)  

_______ Pastrami on Marble Rye                 _______ Smoked Ham & Cheese
                                                                        on Sourdough

_______ Roast Beef Croissant Sandwich       _______ Tarragon Chicken on Pita

_______ Turkey Croissant Sandwich            _______ Tuna Salad on Pita


To register, send in this form with a check for $25.00 made out to:
Diocese of Scranton
by: Monday, May 1, 2006 .  

Kindly mail form to:          

Rev. Philip A. Altavilla
St. Thomas More Parish
P.O. Box 188
Lake Ariel , PA 18436-0188

If you have any questions, you can call 570-698-5584
or e-mail Fr. Altavilla at frfrosty@verizon.net