NEDA  Pastors' Conference

Please provide the following contact information:

First Name
Last Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Work Phone
Home Phone
E-mail

Enter the name of your church in the space provided below.

Enter the location of your church in the space provided below.

Enter the names of others from your church who are attending the conference in the space provided below.

The cost is $40 per person and includes a catered lunch. Please enter the total number of people you are registering and the total amount due in the boxes below.

Number of people   X $40 =  $ .00  Total amount due

Checks are payable to "NEDA" and should be mailed, along with a copy of this form, to:

Doris McAusland

29 Marshall

Windsor Locks, CT 06096

 

May we suggest that you print out two copies of this form?  Keep one for your records and mail one with your check.

 

Please be sure to click on the submit button below.

 

Thank you for registering online!