2026 DISTRICT CONFERENCE REGISTRATION

2026 DISTRICT CONFERENCE REGISTRATION

District Conference Registration

Due by May 15, 2026

Use this form to register persons from your church who will attend the Northeast District Conference to be held at Bethany Wesleyan Church, 675 Blue Mountain Dr., Cherryville, PA on June 11-12, 2026.
Church
Listed by City
MINISTERIAL DELEGATES, LAY DELEGATES AND LAY DBA MEMBERS
1. Last Name
First Name
Ministerial Delegate, Local Church Lay Delegate or Lay Member of the DBA?
2. Last Name
First Name
Ministerial Delegate, Local Church Lay Delegate or Lay Member of the DBA?
3. Last Name
First Name
Ministerial Delegate, Local Church Lay Delegate or Lay Member of the DBA?
4. Last Name
First Name
Ministerial Delegate, Local Church Lay Delegate or Lay Member of the DBA?
5. Last Name
First Name
Ministerial Delegate, Local Church Lay Delegate or Lay Member of the DBA?
6. Last Name
First Name
Ministerial Delegate, Local Church Lay Delegate or Lay Member of the DBA?
7. Last Name
First Name
Ministerial Delegate, Local Church Lay Delegate or Lay Member of the DBA?
8. Last Name
First Name
Ministerial Delegate, Local Church Lay Delegate or Lay Member of the DBA?
9. Last Name
First Name
Ministerial Delegate, Local Church Lay Delegate or Lay Member of the DBA?
10. Last Name
First Name
Ministerial Delegate, Local Church Lay Delegate or Lay Member of the DBA?
11. Last Name
First Name
Ministerial Delegate, Local Church Lay Delegate or Lay Member of the DBA?
12. Last Name
First Name
Ministerial Delegate, Local Church Lay Delegate or Lay Member of the DBA?
NON-VOTING GUESTS - $60/person

Payment required when submitting the registration form.
1. Last Name
First Name
2. Last Name
First Name
3. Last Name
First Name
4. Last Name
First Name
5. Last Name
First Name
6. Last Name
First Name
All delegates and non-voting guests MUST pre-register!
Enter the Number of Delegates and Non-voting Guests attending conference
prevnext( X )
Number of Delegates

Free Number of Delegates

Number of Non-Voting Guests
Cost includes Thursday Dinner, Ordination Reception and Friday lunch.

$60.00 Number of Non-voting Guests
Item subtotal:$0.00

Total

$0.00
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Payment Methods

Debit or Credit Card

Choose from one of the PayPal options to make your payment.

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