2024 Conference Registration | Unity Southwest Region

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Honorific:

Mr.

Mrs.

Ms.

Rev.

Dr.

Other…

Contact Information:

First Name:

Last Name:

Name exactly as you would like it to appear on your name badge (if you would like your honorific to be included, please make sure to use it here):

Email Address:

Mailing Address:

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Preferred Phone Number:

Type:

Landline

Mobile

Alternate Phone:

Name of Your Ministry:

Your Role in Your Ministry (e.g. Senior Minister, Associate Minister, LUT, Board Member):

Reservation Details (All rooms have only twin beds)

Reservation Type:

Single $1350 – private room

Double $1000 – shared room

Conference Only (no on-site sleeping accommodations) $700

All registration types (including “conference only”) include meals:
• Dinner on 10/28
• Breakfast, Lunch and Dinner on 10/29 & 10/30
• Breakfast and Lunch on 10/31

Payment:

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