Midwest Regional Conference Registration

Midwest Regional Conference-- Chicago
September 26-28, 2017

Registration must be received by September 7, 2016

* Indicates required field

Name *

First

Last

Phone Number *

Email *

Church/Institution *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Room Type (All rooms non-smoking) *

Roommate Preference *

Active Pastors *

$125 per active pastor (even if he should excuse himself from this mandatory conference)

Church Workers/ED Staff *

$75 per Professional Church Worker or English District Staff

Vicar/Retired *

$50 per Vicar, Emeritus Pastor, Retired Church Worker

Food/Lodging *

$170 per person

Single Room *

Add $40 for a single room

Commuter *

$90 if not staying at The Cenacle

Spouse Food/Lodging *

$170 per Spouse (food and lodging)

Total Amount Due *

Please add up all Registration Fees+Food/Lodging and enter amount in the box.

Travel *

Driving Own Car Bus or Rail Flying Riding in Car with others

Travel Info *

If driving please list other passengers.

If traveling by bus, rail, or airline, please list:
Carrier
Flight or Route Number
Arrival Time

Submit