REGISTRATION After Registration please check your mail to print your Conference Slip Full Name Gender BrotherSister_______________________________________ Age Bracket 19 years20 to 25 years26 to 30 years31 to 40 years41 years above_______________________________________ Phone Number Valid Email Marital Status SINGLEMARRIEDWIDOWDIVORCEDSEPARATED_______________________________________ Diocese/Region ABAABAKALIKIAHIARAAWKABENINCALABARENUGUISELLEUKULOGISSMAKURDINSUKKAOGOJAOKIGWEONITSHAORLUOWERRIPORT HARCOURTUMUAHIAUYONORTHERN REGIONDIASPORAOTHERS_______________________________________ Please specify your Diocese or Location Department YOUTH TEACHERCHILDREN TEACHER_______________________________________ Post DIOCESAN COORDINATORASSIST. DIOCESAN COORDINATORDISTRICT COORDINATORPARISH COORDINATORAST. PARISH COORDINATOR_______________________________________ Any other position in the church Distric PastorParish PastorWomen LeaderPastors WifePrayer MinisterDeliverance MinisterEvangelism MinisterDrama MinisterMediaElectricalChoristerDecorationCampus CoordinatorOthers_______________________________________ Occupational Status EmployedSelf-EmployedUnemployed_______________________________________ Payment Status I have paidI will pay nowI will pay at the Camp_______________________________________ Amount Δ
