Candidacy Summit January 2019

Please note, you are not registering for New Places for New People Church Planting Discernment Retreat, January 25, 2019.

*First Name
*Last Name
*Address 1
*City
*State
Zip
*Phone
*Email
*Date of Birth
*District:
*Home Church:
*Gender
Male
Female
*Student
Yes
No
College or University Attending:
Expected Graduation Date:
Dietary
We will do our very best to meet your dietary restrictions. Please note any dietary concerns below. However, you are encouraged to bring your own meals.

A refrigerator is available for use, if you choose.

*Psychological

Have you completed a psychological?

Yes
No
*Registration Fee ($125)

Please note, you are not registering for New Places for New People Church Planting Discernment Retreat, January 25, 2019.

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