SEJ Cabinet Consultation 2019 Commuter Form
January 26 - 29, 2019 • Epworth By The Sea
Position / Title:
$218.00 Per Person Includes registration fee, Monday lunch, Tuesday lunch and
grounds fee for Commuters
How many Commuters at $218.00/each?
How many Banquet attendees @ $34.76/each?
Please make your Banquet Entree selection below
and indicate how many of each you're ordering:
Full Payment is due by December 28, 2018.
Epworth Cancellation Policy:
Any cancellations after December 28, 2018 will forfeit the entire person charge.
Make check payable to Epworth By The Sea.
Check Amount: $
OR Enter Credit Card Payment Below:
Name on Card
Credit Card Type
Amount to Charge: $
Credit Card Number
3 Digit Security Code
Expiration Date (mm/yy)
Billing Address Zip Code
Check to affirm I am authorized to make these credit card charges.
I Authorize these charges
I am registering for CEU credit.
Please submit this form online, or you may print and FAX to Tiffany Flavell at 912-634-0642 or mail to:
Epworth By The Sea
P. O. Box 20407
St. Simons Island, GA 31522
Phone: 912-638-8688 • Fax: 912-634-0642
For further information please email firstname.lastname@example.org
No phone reservations accepted. No pets or alcohol. Check-in: 4:00pm - Check-out: 11:30am
* CONFIRMATION OF YOUR RESERVATION WILL BE MAILED OR E-MAILED TO YOU *
This form is for Epworth By The Sea Housing ONLY.