Great Lakes Annual Conference Registration Fee Waiver Request
Full Name
*
First Name
Last Name
E-mail
*
example@example.com
Phone Number
*
Format: (000) 000-0000.
Your Location
*
Street Address Line 2
City
State / Province
Postal / Zip Code
Local Church Name
*
Are you a youth worker with 5+ youth attending annual conference from the same church?
*
Yes
No
Are you a voting delegate to annual conference?
*
Yes
No
Is your local church able to pay a portion of your registration?
*
Yes
No
How much is your local church able to contribute?
*
Why is your church unable to pay for a portion of your registration?
*
Select one
*
Laity
Clergy
Signature
*
Submit
Should be Empty: