Conference Registration Form with Payment

Conference & Graduation Registration

June 23 & 24, 2023
Full Name*

PrefixFirst NameLast Name
Spouse's Name

PrefixFirst NameLast Name
First time to attend conference?*

YesNo
Name on Badge w/ Title*

PrefixFirst NameLast Name
Your Banquet Meal

BeefChickenVegetarian
Spouse's Name on Badge w/ Title

First NameLast Name
Your Spouse's Banquet Meal

BeefChickenVegetarian
E-mail*
example@example.com
Cell Phone Number*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Graduates Only
If you are a new Logos Global Network member since July 2022: Clergy Credentials or Subordinate, please select your status and enter your subordinate name, if applicable.

We would like to recognize you and/or your ministry during the Ordination Service.
LGN Status*

Yes, I am a NEW LGN member (clergy credentials)Yes, I am a NEW LGN member (subordinate)Yes, I am a current LGN member (clergy credentials & subordinate)No, I am not a LGN member.
Subordinate Name blank

Registration Payment

Conference/Graduation SingleIncludes Banquet, Breakfast Saturday Morning, All Workshops (both Friday and Saturday) and Graduation.

$189.00

Conference/ Graduation CoupleIncudes Banquet for two, Breakfast for two Saturday Morning, All Workshops (both Friday and Saturday) for two and Graduation.

$259.00

Vendor Table

$75.00

Saturday Workshops/GraduationIncludes Workshops on Saturday Only and Graduation.

$65.00

Graduation Only

$50.00

Banquet OnlyBanquet for one Friday Night.

$85.00 Quantity

Total

$0.00

Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year
Billing Address
Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Payments are being processed by The Georgia Christian Counselors Association.
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Conference & Graduation Registration