North American Initial Certification Training - Nov. 2-4, 2016 (Hosted by: Ames-Des Moines CityChurch, 2400 Oakwood Rd., Ames, IA) | North American Registration Center

North American Initial Certification Training - Nov. 2-4, 2016 (Hosted by: Ames-Des Moines CityChurch, 2400 Oakwood Rd., Ames, IA)

Name: *

Church Name: *

Church Mailing Address:

Street: *

City: *

State: *

Zip: *

Church Shipping Address: (if different from mailing)

Street:

City:

State:

Zip:

Ministry Role: *

Office Phone: *

Ext. #:

E-mail: *

Mobile Phone: *

Your Mailing Address (if different from church):

Residential

Business

Street:

City:

State:

Zip:

Your Shipping Address (if different from church):

Residential

Business

Street:

City:

State:

Zip:

Friday Evening Banquet

Friday Nov. 4: *

Entree:

Registration Fee: $300.00**

Payment for Initial Certification materials will be taken at the registration table upon your arrival.