Western New York Conference Registration

Please check one: Rt. Rev. Dr. Rev. Mr. Mrs. Ms.*
Please check all that apply:
Bishop Presiding Elder Pastor Evangelism Missionary Christian Education Lay Council Minister’s Spouse Youth Delegate Alternate Delegate

Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState

Post/ Zip Code

Home Phone

Area CodePhone Number

Cell*

Area CodePhone Number

E-mail*

Church*

A.M.E. Zion Church

Presiding Elder District *

Annual Conference *

Emergency Contact*

Name (First, Last)Number

Please indicate your need for special assistance or dietary requirements:

Cancellations and Refunds: Registration fees are non-refundable.

**All periodicals will be mailed to the address provided on this registration form. Please be sure to double check all information.

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Registration

Registration
product

Ministers, Conference/District Officers, & General Registration$300.00

General Public Registration Includes: The Official Conference Program and Packet, Meal Tickets, and ALL Periodicals.

Pastors & Delegates Registration$600.00

General Public Registration Includes: The Official Conference Program and Packet, Meal Tickets, and ALL Periodicals.

Administration fee$3.00

Total $0.00

Payment Methods

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Registrant Information

Payment Methods