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Registration Form
Name________________________________________________________________________________________
Address__________________________________________________________ Phone_______________________
City, State, & Zip Code___________________________________________________________________________
Email ________________________________________________________________________________________
Church Name___________________________________________________________________________________
Address__________________________________________________________ Phone_______________________
City, State, & Zip Code____________________________________________________________________________
Please check the appropriate items:
_____ $50 Registration Fee
[No additional
registration fee for wives if their husband is registered.
Please add wife's name on form if
she is attending.
No additional registration for
children under 17.]
_____ $20 Student Fee (Scholarships available)
_____$25 Daily registration fee. Specify which day: ___________________.
____ Pastor ___ Deacon ___ Lay Person ___ Student
____ Interested in Conference Meals
($18 for 3 meals at the church if paid in advance—payable to SB Founders Conf.
Midwest.
If purchased at the conference, the cost will be $7 per meal as available.)
Return this form
with registration fee to · SB Founders Conf. Midwest ·
RETURN TO SBFC
RETURN TO SBFCMW
SCHEDULE
LOCATION
REGISTRATION