Whitworth University Emergent Mainline Dialogue Conference

Weyerhaeuser Center

Emergent Mainline Dialogue Conference - Registration

Please note: the program cost is $10 for students and $65 for all others.
Prefix (Mr., Mrs., Ms., Rev., Dr., etc.) (required)
First Name (required)
Last Name (required)
Are you a student? (required): NoYes
If you are a student, what school are you currently attending?
If you are a student, what is your year in school?
Mailing Address Type (required): ChurchHome
Address (required)
City (required)
State/Province (required)
ZIP/Postal Code (required)
Work Phone: ( ) -
Home Phone (required): ( ) -
Fax: ( ) -
E-Mail (required)
Church/Organization Name (required)
Your Current Position (required): Pastor; Lay leader in the church or other Christian organization; Other
How did you hear about the program?: Brochure E-mail Newspaper ad

Word of mouth Other
Program Cost: $