2020 Conference Online Registration Form

Registration Type *

Full Name *

First Name Last Name

Name

First Name Last Name

Name

First Name Last Name

Spouse

Prefix First Name Last Name

First time to attend conference? *

Yes No

Name Badge *

Preferred Name For Conference Badge Ex Pastor, Dr.

Spouse Name Badge

Preferred Name For Conference Name Badge

Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country

Present E-mail *

myname@example.com

Cell Phone Number *

Area Code Phone Number

Other Phone Number

Area Code Phone Number

Graduates Only

Conference Volunteer *

If yes, Thank you in advance. A conference team member will follow-up with you.

FOR PAYMENTS ONSITE:

Onsite payments will be accepted via credit/debit card and cash.

Please note that onsite payments are not be eligible for the early bird discount.

Pay Fees By

Select Payment Method

CONFERENCE FEES

Early Bird Conference Single $ 129.00

Early Bird Conference Married $ 179.00

Single (After September 4th) $ 149.00

Married (After September 4th) $ 199.00

Graduation Only $ 25.00

Full Page Ad $ 175.00

You may purchase an ad in the conference booklet. The ad can be used to introduce your ministry or business, and/or congratulate a graduate.

1/2 Page Ad $ 100.00

You may purchase an ad in the conference booklet. The ad can be used to introduce your ministry or business, and/or congratulate a graduate.

1/4 Page Ad $ 50.00

You may purchase an ad in the conference booklet. The ad can be used to introduce your ministry or business, and/or congratulate a graduate.

GALA TABLE SPONSOR $ 350.00

For your gala table sponsorship you will receive conference access (for two) for all events, including the Gala Dinner • 2- Conference Registrations ($99 Value) • 2-Gala Ticket Complimentary ($90 Value) • 1/2 Page ad in conference booklet ($100 Value) • Vendor Table ($75 Value) during entire conference Additionally, we will provide a professionally made table card with your organization’s name and you may provide brochures or business cards at your table. The table will seat 10, and you will be hosting 8 paying guests. The Master of Ceremonies will also acknowledge all our Table Sponsors during the gala. (If your prefer, you may share with another ministry and split the cost and benefits).

VENDOR TABLE $ 75.00

(limited availability, Gala Sponsors get first choice) A vendor table will be provided for both days of the conference for you to display your ministry and/or business, share your story, and sell items and materials.

Total $ 0.00

Credit Card Owner
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year
Billing Address
Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country