Church Name
Pastor's Wife Name
First Name
Last Name
Registrant Name
*
Email
example@example.com
Phone Number
Please enter a valid phone number.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Submit
CONFERENCE REGISTRATION PAYMENT MADE EASY WITH STRIPE!
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Conference Registration Fee
Per Lady
$
25.00
Quantity
1
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Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Should be Empty: