Equipping Ministries International

Personal Information

10First Name:

11Last Name:

12Gender:

12Title:

20Street Address:

22City:

23State:

24Zip:

25Country:

30Phone Number:

40Church Name:

41Church City & State:

50Select Workshops
Enter the workshop code of your top 3 choices for the 2 workshop times (i.e. W4, W1, W10).

51Enter your three preferences:

52Additional Information

52Need Child Care (infant/preschool):

Call Lebanon Presbyterian Church (513-932-2751) with name and age of children to make the reservation

53Lunch Preference:

Ham

Turkey

Veggie

61Breakout Lunch (optional):

Youth

Small church

71Special Needs
wheelchair, hearing, allergies, etc.

74Age:

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