13th Annual Regional Conference – 2026 Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Participant Name *FirstLastParish Name * 4 2 4 Address *Address Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeEmail *Phone * Participant Names Name 1Group 1Adult MaleAdult FemaleBoysGirlsAllergies 1Name 2Group 2Adult MaleAdult FemaleBoysGirlsAllergies 2Name 3Group 3Adult MaleAdult FemaleBoysGirlsAllergies 3Name 4Group 4Adult MaleAdult FemaleBoysGirlsAllergies 4Name 5Group 5Adult MaleAdult FemaleBoysGirlsAllergies 5 Payment Details Conference Fees $35 USD per adult above 18 yrs Kindly make the check payable to “Mar Thoma Church Of SF” Payment via Zelle to : trustees@marthomasf.org Memo: WR-MTVEA Conference Hotel Room Block (Optional) Double Tree by Hilton, Livermore, CA Reserved block of rooms at discounted rate of $99/day +tax, 2 queen beds Group Code: CDTMAR Accomodation AccomodationI'll block at HiltonI'll arrange my ownProvide SpecificsSubmit Contact Details Mr. Kurien IdicullaConference ConvenerTel: (209) 996-4094. Email: kuriensally@gmail.com Mr. Rajesh MathewRegional SecretaryTel: (602) 625-7043. Email: rajeshmtvla@yahoo.com “You will be my witnesses” (Acts 1: 8)