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Seminar Registration Form

1 min read
21 Mar


  1. Full Name: _________________________________________________________
    Email Address: _____________________________________________
    Phone Number: ____________________________________
    Address (church): ________________________________________________________________
    City: _________________________________________________
    State/Province: ___________________________________________
    Zip/Postal Code: _____________________________________________
    Church Name: ________________________________________________
    Status (i.e. president, secretary, member, etc.): ____________________________ 
  2. Seminar Details: Seminar
  3.  Seminar Title: “Parents as a spiritual guide”
    Date:
    Time: 9:00am
    Location: 1040 Union Blvd Bayshore, NY 11706 Registration Type (Please select one): 
    • Individual Participant
    • Group Registration (Please specify number of participants)
  4.  Donation Information: 
    • Cash Donation (can made same day of seminar)

    • I agree to abide by the rules and regulations set forth by the seminar organizer.
  6.  Submit  
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