Ministry Assessments

Leadership Conference
Full Name*

First NameLast Name
Church Name*
Title*
E-mail*
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number*

Area CodePhone Number
Registration*
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Leadership Conference Registration$125.00

Teen Registrants$25.00

Subtotal $0.00Tax $0.00Total $0.00
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