Blue


2018 "Honey" Conference Registration

$10 per Service

 Only one registrant per form please.  Non-refundable, but transferable registration fee
per person
must accompany this registration information.


Pastor Darlene McCarty (Friday Morning)
Elder Sherrilyn Willaims (Friday Afternoon)
Martha Tennison (Friday Night)
Beth Stephens (Saturday Morning)
Number of Services I am Registering for:

GENERAL INFORMATION:

Position In Church or Ministry
Ms/Mrs/Rev/Mr
Name
First Name
Middle
Last Name
E-mail
Re-type E-mail
Telephone: Day
Telephone: Evening

CHURCH INFORMATION:

Church Ministry/Organization
Church Mailing Address
Address Line 1
Address Line 2
City
State/Prov.
Postal Code
Church Phone
Contact Person: Group Registration
Contact Person: Phone Number
Contact Person: E-mail

CREDIT CARD INFORMATON:

Payment Option
Credit Card #
Expiration Date
Security #
Name Printed on Card
Card Holder's Phone Number
Billing Address if different than above
Address Line 1
Address Line 2
City
State/Prov.
Postal Code
Comment or Special Instructions:

OFFICE USE ONLY:
File #______________ Received _____________DD_____________Received_____________