Registration Form

Bishop Elliott Lectures

Date:  _________________________________

Speaker:  _________________________________

Location: _________________________________
Print and send with check payable to:
The Bishop Elliott Society, P.O.B. 368, Corpus Christi, Texas 78403

Name __________________________________________________________
Address ________________________________________________________
City, State, Zip ___________________________________________________
E-mail _________________________________________________________
Telephone ______________________________________________________
Parish _________________________________________________________
    ___ I am not a BES Associate:  send $40.00.
    ___ I am a current Associate of the Society: send no funds, but please register.
    ___ Please enroll/renew me as a BES Annual Associate:  send $100.00 for one year.
    ___ Please enroll me as a BES Life Associate:  send $1,000.00 for lifetime participation.

    Send E-mail inquiries to:  Bpelliottsociety@aol.com  or call 361-739-5808