Address 1:*

Conference Registration

Non-refundable registration fee is $55.00 per person.

First Name:*

Last Name:*

Title:

First time conference

attendee or returning?

Church or Ministry Name:

Address 2:

City:*

State:*

ZIP:*

Phone Number:

Fax:

Email:*

Other Information:

If yes, please select a size and click on the button below:

Would you like to order a Conference T-Shirt for an additional $15.00?

You will be redirected to PayPal where you can enter your method of Payment.

You will be redirected to PayPal where you can enter your method of Payment.

If you can not attend and would like to sponsor a person check box below & complete the entire registration form.

Registration is not complete until paypal method is complete. Click register or register with T-shirt and follow directions. Thank you

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first timereturning

Mr.Mrs.Ms.Dr.Rev.

No T-ShirtSMLXLXXLXXXL

I can not attend, I will sponsor 1 person.