Delegate Registration Form

School Name

School Address

Street Address

Street Address Line 2

CityState

Zip Code

School Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

School Email Address

example@example.com

Principal/Administrator

First NameLast Name

Pastor

First NameLast Name

PLEASE LIST ALL PERSONNEL ATTENDING THE CONVENTION.

Type carefully since this information will be used to make name tags. Please include names of administrators and pastors again on this list in order to register them for the convention. Remember that your church's senior pastor may attend the convention for FREE.

After you complete the fields for one name, a new set of name fields will appear.

Delegate 1

First NameLast Name

Delegate 2

First NameLast Name

Delegate 3

First NameLast Name

Delegate 4

First NameLast Name

Delegate 5

First NameLast Name

Delegate 6

First NameLast Name

Delegate 7

First NameLast Name

Delegate 8

First NameLast Name

Delegate 9

First NameLast Name

Delegate 10

First NameLast Name

Delegate 11

First NameLast Name

Delegate 12

First NameLast Name

Delegate 13

First NameLast Name

Delegate 14

First NameLast Name

Delegate 15

First NameLast Name

Delegate 16

First NameLast Name

Delegate 17

First NameLast Name

Delegate 18

First NameLast Name

Delegate 19

First NameLast Name

Delegate 20

First NameLast Name

Delegate 21

First NameLast Name

Delegate 22

First NameLast Name

Delegate 23

First NameLast Name

Delegate 24

First NameLast Name

Delegate 25

First NameLast Name

Delegate 26

First NameLast Name

Delegate 27

First NameLast Name

Delegate 28

First NameLast Name

Delegate 29

First NameLast Name

Delegate 30

First NameLast Name

Delegate 31

First NameLast Name

Delegate 32

First NameLast Name

Delegate 33

First NameLast Name

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First NameLast Name

Delegate 35

First NameLast Name

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First NameLast Name

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First NameLast Name

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First NameLast Name

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First NameLast Name

Delegate 40

First NameLast Name

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First NameLast Name

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First NameLast Name

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First NameLast Name

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First NameLast Name

Delegate 45

First NameLast Name

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First NameLast Name

Delegate 47

First NameLast Name

Delegate 48

First NameLast Name

Delegate 49

First NameLast Name

Delegate 50

First NameLast Name

The Early Registration fee for AACS members is $55 per delegate and is good through October 23. The Late Registration Fee for AACS members is $60 per delegate and applieas after October 23. The Registration Fee for non-AACS members is $70 per delegate. Each senior pastor may attend for free. You may choose to pay by check or online.

Payment Method

Payment

ODACS Convention Delegates (AACS Member, Early Registration)

The Early Registration Fee is good through October 23. Select the total number of delegates, but do not include your senior pastor in the total.

$55.00 Number of Delegates

ODACS Convention Delegates (AACS Member, Late Registration)

The Late Registration Fee applies after October 23. Select the total number of delegates, but do not include your senior pastor in the total.

$60.00 Number of Delegates

ODACS Convention Delegates (non-AACS Member)

The non-AACS Fee applies to all schools that are not AACS members. Select the total number of delegates, but do not include your senior pastor in the total.

$70.00 Number of Delegates

Total

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Expiration Month	Expiration Year

Delegate Registration Form

Payment*

Payment