Register For Women's Conference 2018 Time left to complete this form:  
  Please provide the information below. * Means required. 2/19/2018 2:23:46 AM  
 
Workshops*  
 
 
Early Bird Workshop   Womens Ministry logo
 
Special Interest Workshop*  
 
Special Interest Workshop 2*  
 
Bonus Workshop  
 
 
 
Travel Information  
 
 
Bus ($45 from The Greater Allen A.M.E. Cathedral of NY)*
 
 
Additional Information  
 
  Are you a committee member?*
Which committe are you in?
Select one (If applicable)
 
  T-Shirt Size:
 
  Years attending conference  
 
Personal Information  
 
  Title:*  
  Last Name:*
First Name:*
Middle Init:
Age range?*
 
  Address:*
City:*
State:*
Zip:*
 
  Country
Phone 1*
(Use format: XXX-XXX-XXXX):
Phone 2
(Use format: XXX-XXX-XXXX):
  Emergency Contact*
Emergency Contact Phone*

Emergency Contact Relationship*

 
  Email:
Church: Check if Allen*
Pastor: Check if Rev. Dr. Floyd H. Flake*
  PICTURE UPLOAD - Please upload a passport or headshot picture only. Only jpg, gif or png images are allowed.
Pictures should be no larger than 1 MB in size. Pictures will be sized to 100 pixels wide by 120 pixels tall.

 
  Comments:

 


 
 
Registration *  
 
 

Registration Type and Cost*

 
Important Information

Cancellation/Refund Policy
HARDSHIP CANCELLATIONS ONLY i.e. sickness or death. WILL BE ACCEPTED WITH WRITTEN NOTIFICATION NO LATER THAN  04/19/2018. SUBMIT WRITTEN NOTIFICATION TO: Women's Registration Committee, GAC, 110-31 Merrick Boulevard, Jamaica, N.Y. 11433. All approved refunds will be returned less $50.00 processing fee after the Conference. Please allow three weeks after conference for refund.

Check Policy
There will be a service charge of $35.00 for each returned check.
Checks are accepted until April 2, 2018.

 
   
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