WELCOME TO THE ONLINE REGISTRATION

PERSONAL INFORMATION


Note: Your badge will be printed using the exact badge name provided in the field above. If no badge name is provided then your first and last name will be used.

Address, Phone and E-mail

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Emergency Contact

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Ethnicity

If your ethnicity is not appropriately listed (Other Not Listed) with the options above, please use the field below to tell us your ethnicity:

Additional Information

Congregation Information



REGISTRATION OPTIONS

Pre-Convocation Event Registration

Pre-Event Institute  |  Fee: $50.00

Thursday, July 19, 9am - 4pm
Clergy Institute or Lay Leaders Institute
 

Registration Type







PLEASE NOTE:

SINGLE REGISTRATION: Once you've filled in the form and select the registration type, you can scroll to the bottom of the page and click Next Page to finish and pay for your registration. 

MULTIPLE REGISTRATIONS: If you wish to register more than one individual, simply after you've filled in the registration form for the first person, scroll to the bottom of the page and click NEXT PAGE.  

If you encounter any problems with your registration process, or should you have any question, please contact Brenda Rossy, via email at brossy@disciples.org or via phone at (317) 713-2416.


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