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2012 Conference Registration Form.

(1) You must contact Larry Deeds by phone if you indicate below that you wish to have lodging provided for you by a family from the assembly hosting the conference.

(2) Leaving the page without pressing submit will result in your registration not being sent in.

Required *

Last Name *

First Name *

Mailing Address *

City *

State / Province *

Postal Code *

Who is coming with you?

Phone Number *

Email Address

Will you be Flying or Driving? *

Your flight details:

Do you have any dietary, accomodation, or other special needs we should know about?

What type of accomodation do you need? *

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