Please enable JavaScript in your browser to complete this form.Registration for PAIG Retreat 2024 Fill out the form fields below to register for PAIG's in-person retreat at the Malvern Retreat House, September 27-29, 2024. Asterisked fields are required.Your Info:Name *FirstLastEmail *Phone *United States +1United States+1United Kingdom+44Afghanistan+93Albania+355Algeria+213American Samoa+1Andorra+376Angola+244Anguilla+1Antigua & Barbuda+1Argentina+54Armenia+374Aruba+297Ascension Island+247Australia+61Austria+43Azerbaijan+994Bahamas+1Bahrain+973Bangladesh+880Barbados+1Belarus+375Belgium+32Belize+501Benin+229Bermuda+1Bhutan+975Bolivia+591Bosnia & Herzegovina+387Botswana+267Brazil+55British Indian Ocean Territory+246British Virgin Islands+1Brunei+673Bulgaria+359Burkina Faso+226Burundi+257Cambodia+855Cameroon+237Canada+1Cape Verde+238Caribbean Netherlands+599Cayman Islands+1Central African Republic+236Chad+235Chile+56China+86Christmas Island+61Cocos (Keeling) Islands+61Colombia+57Comoros+269Congo - Brazzaville+242Congo - Kinshasa+243Cook Islands+682Costa Rica+506Croatia+385Cuba+53Curaçao+599Cyprus+357Czechia+420Côte d’Ivoire+225Denmark+45Djibouti+253Dominica+1Dominican Republic+1Ecuador+593Egypt+20El Salvador+503Equatorial Guinea+240Eritrea+291Estonia+372Eswatini+268Ethiopia+251Falkland Islands+500Faroe Islands+298Fiji+679Finland+358France+33French Guiana+594French Polynesia+689Gabon+241Gambia+220Georgia+995Germany+49Ghana+233Gibraltar+350Greece+30Greenland+299Grenada+1Guadeloupe+590Guam+1Guatemala+502Guernsey+44Guinea+224Guinea-Bissau+245Guyana+592Haiti+509Honduras+504Hong Kong SAR China+852Hungary+36Iceland+354India+91Indonesia+62Iran+98Iraq+964Ireland+353Isle of Man+44Israel+972Italy+39Jamaica+1Japan+81Jersey+44Jordan+962Kazakhstan+7Kenya+254Kiribati+686Kosovo+383Kuwait+965Kyrgyzstan+996Laos+856Latvia+371Lebanon+961Lesotho+266Liberia+231Libya+218Liechtenstein+423Lithuania+370Luxembourg+352Macao SAR China+853Madagascar+261Malawi+265Malaysia+60Maldives+960Mali+223Malta+356Marshall Islands+692Martinique+596Mauritania+222Mauritius+230Mayotte+262Mexico+52Micronesia+691Moldova+373Monaco+377Mongolia+976Montenegro+382Montserrat+1Morocco+212Mozambique+258Myanmar (Burma)+95Namibia+264Nauru+674Nepal+977Netherlands+31New Caledonia+687New Zealand+64Nicaragua+505Niger+227Nigeria+234Niue+683Norfolk Island+672North Korea+850North Macedonia+389Northern Mariana Islands+1Norway+47Oman+968Pakistan+92Palau+680Palestinian Territories+970Panama+507Papua New Guinea+675Paraguay+595Peru+51Philippines+63Poland+48Portugal+351Puerto Rico+1Qatar+974Romania+40Russia+7Rwanda+250Réunion+262Samoa+685San Marino+378Saudi Arabia+966Senegal+221Serbia+381Seychelles+248Sierra Leone+232Singapore+65Sint Maarten+1Slovakia+421Slovenia+386Solomon Islands+677Somalia+252South Africa+27South Korea+82South Sudan+211Spain+34Sri Lanka+94St. Barthélemy+590St. Helena+290St. Kitts & Nevis+1St. Lucia+1St. Martin+590St. Pierre & Miquelon+508St. Vincent & Grenadines+1Sudan+249Suriname+597Svalbard & Jan Mayen+47Sweden+46Switzerland+41Syria+963São Tomé & Príncipe+239Taiwan+886Tajikistan+992Tanzania+255Thailand+66Timor-Leste+670Togo+228Tokelau+690Tonga+676Trinidad & Tobago+1Tunisia+216Turkey+90Turkmenistan+993Turks & Caicos Islands+1Tuvalu+688U.S. Virgin Islands+1Uganda+256Ukraine+380United Arab Emirates+971United Kingdom+44United States+1Uruguay+598Uzbekistan+998Vanuatu+678Vatican City+39Venezuela+58Vietnam+84Wallis & Futuna+681Western Sahara+212Yemen+967Zambia+260Zimbabwe+263Åland Islands+358Location (City, State)Roommate *I already have a roommatePlease assign me a roommateI'm rooming with (enter roommate's name):Cost:Cost per person, double occupancy *Price: $270.00Includes 2 nights accommodations, double occupancy and 5 meals (Breakfast, Lunch and Dinner on Saturday; Breakfast and Lunch on Sunday)Would you like to contribute to the Retreat Scholarship Fund? The fund helps others who cannot afford to attend.YesScholarship DonationTotal$270.00Payment:Please indicate your intended payment method *Credit Card (secure transaction via Stripe)Check (MUST be postmarked by September 13, 2024)Please enter your credit card info below.Stripe Credit Card *CardName on CardIf you plan to pay by check, please make your check payable to PAIG OA and send it to: Shari Basch 2717 Susquehanna Rd Abington, PA 19001 Checks need to be postmarked by September 13, 2024.Need Financial Assistance?If you're not able to afford the cost, please add a note below. You'll be entered into a drawing for a scholarship to attend the retreat at no charge. Scholarships are limited. PAIG makes no guarantee for scholarship awards.Note: If you are requesting financial assistance, please select "Check" as the payment method above.Other Info:Are you a newcomer (within first year of Program)?YesIs this your first OA retreat?YesDo you have any physical disabilities or challenges? If yes, please describe below.Service:Are you willing to be of service? If yes, indicate your interest.Workshop Leader / Speaker (minimum of 3 months abstinence required)Registration / Craft Table / Other (no abstinence requirement)Want to participate in the Fashion Show on Saturday night?Yes, I want to show off my wares!MaybeGot talent?Yes, I want to partake in Saturday night's Talent Show!MaybeDescribe your talentPlease be patient and do NOT refresh your browser after you click on Submit. If you have any questions or problems registering, please send an email to PAIGRetreatTreasurer@gmail.comSubmit