GA North Region - Annual Conference

Georgia North Region

REGISTRATION FORM
Registration Fee: $130.00 (includes processing fee)

In-Person Event
Title
Full Name

First NameMiddle NameLast NameSuffix
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
E-mail
example@example.com
Mobile Number
Format: (000) 000-0000.
Home Number
Format: (000) 000-0000.
Select District
Local Church Name
Membership (Select all that apply)
Are you a delegate or alternate?
Payments are processed through PayPal. You may pay using an existing PayPal account, or any major credit card / debit card.
Registration Fees
prevnext( X )
Clergy
(includes $5.00 processing fee)

$130.00



Delegate or Alternate
(includes $5.00 processing fee)

$130.00



Laity
(includes $5.00 processing fee)

$130.00



Guest
(includes $5.00 processing fee)

$130.00



Youth (13-17)
(includes $1.25 processing fee)

$26.50



Children (12 and under)
Free Quantity



Total

$0.00

Georgia North Region