2012 Youth Conference Registration

Name

First
Last
Male or Female
 Male 
 Female 
Email
Phone Number

###		 -
###		 -
####
Address

Street Address

Address Line 2

City
State / Province / Region

Postal / Zip Code
Country
Church Name
Church Address

Street Address

Address Line 2

City
State / Province / Region

Postal / Zip Code
Country
Conference Role
 Teen 
 Youth Worker 
 Youth Pastor 
 Pastor 
Will you need housing while attending the Conference?
 Yes 
 No 
If you are providing your own housing, will you need a list of area hotels?
 Yes 
 No 
Will you be purchasing the $40 meal ticket?
 Yes 
 No 
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Our Location

Windsor Hills Baptist Church

5517 NW 23rd St.

Oklahoma City, OK 73127

Phone: (405) 943-3326

Fax: (405) 943-3712