ILI Registration Form - Module 2 - Wichita, KS July 2026

ILI Registration Form

Please complete one registration form per person attending.
ILI Training July 20th - July 22nd

Asbury Church

2810 W 15th St N

Wichita, KS 67203

Cost is $30 per person

Monday, July 20th - 8:30am - 6pm

Tuesday, July 21st - 9am - 6pm

Wednesday, July 22nd - 9am - 1pm

Lunch will be provided on Monday and Tuesday

*You must attend all the session to receive your certificate.

Please bring your bible!
Name*

First NameLast Name
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
E-mail*
example@example.com
Mobile Number*
Format: (000) 000-0000.
Emergency Contact Name*

First NameLast Name
Emergency Contact Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Church Name*
The Heartland Conference’s Board of Ministry has approved ILI History Makers Modules 1 and 2 as eligible coursework for advanced credit toward the Conference’s Certified Lay Ministry (CLM) training program. Please check this box if you would like to apply your completed coursework toward CLM credit.*

YesNoN/A
Please use the drop down list to select Food Allergies. *

ILI Registration*

Registration

$30.00 Quantity
Item subtotal:$0.00

Total

$0.00