National Association Women of the Church Of God
West Middlesex, PA | www.nawcg.org | 1-844-MYNAWCG | 1-844-696-2924
2018 Convention Registration/Annual and Lifetime Membership/Donation Form
Name
*
Prefix
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
example@example.com
Phone Number
*
-
Area Code
Phone Number
Cell Phone
-
Area Code
Phone Number
Church Name
First Name
Last Name
Church Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Women's Ministry Leader Name
Pastor's Name
Convention Registration Fees
*
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Saturday - PRAYER BREAKFAST - ONLY
$
25.00
Quantity
Banquet ONLY
$
55.00
Quantity
One Day Registration (includes Breakfast on Saturday)
$
35.00
Quantity
Registration Per Person (Includes Breakfast & Banquet)
$
145.00
Quantity
Group Rate 10+ (Rate Per Person) (PLEASE CALL)
$
139.00
Quantity
Total
$
0.00
Arrival Date
-
Month
-
Day
Year
Date
Departure Date
-
Month
-
Day
Year
Date
If you will need a scooter for accessibility?
No
Yes
Additional Registrants
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Submit
Should be Empty: