SECOND MAN CONFERENCE REGISTRATION FORM

SECOND MAN CONFERENCE

October 19 - 21, 2011
7:00 p.m. nightly

 

Circle one          Mr     Mrs     Miss

First Name         ---------------------------------------------------------------

Last Name         ---------------------------------------------------------------

Address             --------------------------------------------------------------- 

City                   ----------------------------------------------------------------

State / Zip          --------------------------------------------------------------
Church / Pastor  ---------------------------------------------------------------

Are you a:  (circle one)     Sr. Pastor     Assoc. Pastor     Adjutant     Staff Minister

 

                                                  PAYMENT

$25.00  Advance............deadline: October 18th, 2011

$30.00  Day of

3 Ways  to Submit Registration:

      (1)  Mail registration form in along with payment

      (2)  Fax in registration form (in order to receive advance price) and pay on day of
             arrival.  Fax to (817) 870-9855 attention: Linda Bryant

     (3)   Register and pay upon arrival (the day of price)