2021 Leadership Seminar Registration
April 16 - 7:30pm | Please fill out this form and click submit.
The cost is $32.00 per person.
The cost includes all sessions and meals. Free childcare is provided for registered children.
Location:
Apostolic Pentecostal Church
2810 Tractor Lane
Bloomington, IL 61704
Speaker: Tim Zuniga
Schedule:
Friday - 730pm
Fellowship Meal to follow for all attendees in the Lower Level Dining Room
Saturday
Breakfast - 8am
Session 1 - 9am
Session 2 - 10am
Session 3 - 11am
Conference Hotel - Doubletree $89
Name
*
Email
*
This address will receive a confirmation email
Childcare
I need child care (ages up to 3)
Please select one option.
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2
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4
Select Option
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2
3
4
4
I need child care (ages 4 to 11)
Please select one option.
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2
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5
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2
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4
5
Please list names and ages of children
Children's Allergies
Registration Payment
Payment
Single Reg (32.00)
2 Reg ($64)
3 Reg ($96)
4 Reg ($128)
5 Reg ($160)
Ladies Sectional Director Registration (0)
NAM Sectional Director Registration (0)
Sunday school Sectional Director Registration (0)
IYM Sectional Director Registration (0)
District Board Registration (0)
Camp Promotional Committee Registration (0)
Staff (0)
Cash or check ($0)
NAM Missionary ($0)
Single Reg (32.00)
2 Reg ($64)
3 Reg ($96)
4 Reg ($128)
5 Reg ($160)
Ladies Sectional Director Registration (0)
NAM Sectional Director Registration (0)
Sunday school Sectional Director Registration (0)
IYM Sectional Director Registration (0)
District Board Registration (0)
Camp Promotional Committee Registration (0)
Staff (0)
Cash or check ($0)
NAM Missionary ($0)
Amount
If paying Cash/Check, please list the ministry couples that will be attending.
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Name on Card
Card Billing Address
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Submit
Description
April 16 - 7:30pm
Please fill out this form and click submit.
The cost is $32.00 per person.
The cost includes all sessions and meals. Free childcare is provided for registered children.
Location:
Apostolic Pentecostal Church
2810 Tractor Lane
Bloomington, IL 61704
Speaker: Tim Zuniga
Schedule:
Friday - 730pm
Fellowship Meal to follow for all attendees in the Lower Level Dining Room
Saturday
Breakfast - 8am
Session 1 - 9am
Session 2 - 10am
Session 3 - 11am
Conference Hotel - Doubletree $89
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