------- REGISTRATION FORM ------

 You may register on-site, but space is limited and admission cannot be guaranteed.

PLEASE print this form and mail with your check.  Thanks!

Type or print your name:

         Check One:      (_ Rev.)   (_ Evan)    (_ Mr.)    ( Mrs.)    (_ Pastor)   (_ Dr.)    (Other _________)

 

Name: ______________________________________________________________________

                            Last                                                        First                                                        MI

 

Present Address _______________________________________________________________

                                               Number and Street                                               City/St/Zip

 

Home Telephone (___)  __________________           Work Phone (___) ____________________

 

Name and Address of your Church/Organization:

_____________________________________________________________________________

                                Number and Street                                                               City/St/Zip

 

Name of your Pastor:   ____________________________________________________________

   

                                                                                                                                  

Individuals Registering:

 

No. of
People		 Registration Individual
Cost		 Total
  Classes $100.00  
  (Click on "Classes" for a complete listing of the classes.)    

 

 

Special Registration for Churches:

 

No. of
People		 Registrants Per Member

Total
  Church - 5 to 10 members by 3/1/05 $ 75.00  
  Church - 10 or more members by 3/1/05    50.00  
       
  Church - 5 to 10 members after 3/1/05 $ 100.00  
  Church - 10 or more members after 3/1/05     75.00  
       

 

Workshops and Banquet

No. of
People		 Registrants Per Person

Total
  Pre-Conference Musical - March 29, 2005 @ 7:00 p.m. $10.00  
     New Light Baptist Church, 650 Blount Road     
       
  Banquet - Individuals $ 35.00  
       
  Banquet - Groups - 8 to a table    280.00  

 TOTAL AMOUNT OF PAID:  _______________

        Paid by:      __ Check            __ Cash

 Make checks payable to:            Christian Bible College

                                                School of Ministries

                        Mail to:

                                                            720 South Blvd.

                                                            Baton Rouge, LA  70802

 

>>>>>> Please register me in the following curriculum:  (check one)

 

□ Pastoral Ministry                                □ Church Leadership

 

 

Course Selection:

 

  Wednesday 3/30/05 Thursday 3/31/05 Friday 4/1/05
Morning      
Evening        ------------------

Note:  Participants should register for either the pastoral or the church leadership track.  These classes will be held on Wednesday and Thursday (all day).  On Friday morning, there is a multiplicity of classes to attend, please make your selection from the curriculum (click on classes link).

Signature  ___________________________________          Date:  __________