Online Registration

First Name
Last Name
Title
Company/Church
Your Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Home Phone
Other Phone
Fax
E-mail
Spouse's Name
Conference Details
Please check the appropriate box below:
2010 Leadership Conference
Choose one of the following options: (Regular Rates are in effect) Adult ($215/person) Couple ($400/couple)
Payment Method
Choose one of the following options:
Check/Money Order Visa Mastercard Discover American Express
If you are paying by credit card, click the submit button below and then make a payment through Paypal.  If you choose to pay by check, you MUST print the completed form and mail with your check/money order to the address below: Pastor and Church Leadership Summit 3816 Edmondson Avenue Baltimore, MD 21229 Attn:  Carol Steward
Notes (additional Information, group members, other details about payments, etc.)
How did you hear about us?  Church Bulletin Pastor Local Church Conference Flyer Internet Other

After you submit this information you will be prompted to select a payment category and make a payment

Your registration is not valid until your registration fee has been paid in full.

A 25% cancellation fee will charged for all cancellation requests within 60 days of the conference date.