NYALC 2023 Registration Form

Full Name *

First Name Last Name

Gender *

Age *

Email *

example@example.com

Phone Number *

Please enter a valid phone number.

Synod *

Presbytery *

Congregation / Faith Community *

What is your cultural / family heritage?

Are you a member of Congress?

Have you been to NYALC before? *

Yes No

If yes, when?

Please tell us about yourself and your involvement in the Church. *

In what ways do you offer leadership in your church or community? *

What are you hoping to learn from NYALC? *

What will you contribute to the leadership of NYALC? *

All participants will need to meet the cost of the Conference. This amount is to be confirmed but is likely to be close to $600 (for conference only). We strongly recommend participants seek sponsorship from their Synod, Presbytery or Congregation.

If I’m selected to attend NYALC I will agree to behave in ways that respect all people and support NYALC being a safe and inclusive community *

I Agree

Can you list one person who will act as a reference for you?

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NYALC 2023 Application Form: