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E-mail Registration

Email Address:
Name:

Address:   Phone#:

City:    State: Zip:

Name of Conference:

Dates of Conference:: 

Church:  Denomination:

I will be attending the conference with my spouse

I will be attending the conference and desire to share a room with the following person(s)  (Please note that both roommates must make the same request)


How did you hear about the Conference?

Please charge my Visa Mastercard
with a non-refundable deposit of $150.00 per person.
Total to be charged:
(Balance due upon arrival)
Credit Card #:

Expiration date (mo / yr):

Please print the Registration/Application form, complete the questionnaire and mail to McLean Ministries at the address given.
 
bluesq.jpg (2290 bytes) To print application form
bluesq.jpg (2290 bytes) Return to home page