Online Registration

 
 

DELEGATES

Mr

Mrs

Dr

First Name

Last Name

Middle Initial

Home Town in Kerala

Street Address

  

City

State

Zip Code

Home Phone

Business Phone

Fax

Assoc. Affiliated in USA

Your Spouse If attending

First Name

Last Name

Middle Initial

Email
 

Your children If attending

First Name

Last Name

Grade

Date Of Birth

 
 
 

Your Parents If Attending

First Name

Last Name

    
     
     
 

REGN. PACKAGES

CONVENTION RATE

SPONSOR

(US $ 995)

BENEFACTOR-

FAMILY (US $300)

BENEFACTOR-

SINGLE ($200)

REGISTRATION FEE

Free for all days

Free for all days

Free for all days

HOTEL ACCOMMODATION

One room, 4 days

Special rates

Special rates

SOUVENIR

½ Page

Name in souvenir

Name in souvenir

BUSINESS LUNCHEON

2 persons

None

None

BANQUET TICKETS

4 persons(2 Main Banquet,
2 Youth Banquet)

2 persons

1 person

TICKETS FOR CULTURAL PROGRAM

4 each for all programs

2 each for 2 programs

1 each for 2 programs
 

BANQUET

(ADDITIONAL TICKETS - PLEASE PROVIDE THE NUMBER OF EXTRA TICKETS NEEDED IN THE BOXES)

MAIN BANQUET (US $65)

YOUTH BANQUET (US $50)

BUSINESS LUNCHEON (US $50)

CULTURAL PROGRAMS (US $20 PER SEAT)

BANQUET MENU PREFERENCES

VEGETARIAN

NON-VEGETARIAN

Please provide the number of persons in each category

BANQUET AND YESUDAS PROGRAM TOGETHER ON JULY 4TH (US $150 PER SEAT)
       
 

Please click on the submit button before make the payment
   

Total

I as an attendee of the FOMAA Convention acknowledge and accept the responsibility of safety, liability and medical insurance for myself & the members listed on the form. I will not hold the FOMAA Committee or the attendees of the conference responsible for the safety & liability during our stay at the conference. In case of an emergency, I give my permission for emergency medical treatment. I agree to abide by the local, state and Federal law. Any damages to the hotel room will be my responsibility. I understand that no refunds will be issued.
 

HOTEL RESERVATION

(Hotel rates do not include tax)  

Bally's Las Vegas

Type of Room
SINGLE/DOUBLE

Rate per Night
$ 99.00 + Tax

Telephone number
(877) 603-4390

Benefactors are responsible to reserve their rooms directly by calling the hotel or website (www.ballyslasvegas.com). Please use the group name “FOMAA 2010” and reserve your rooms well in advance. Rooms for the sponsors will be reserved by FOMAA