Candidacy Summit July 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 contact Susan Brandes with any questions regarding your registration at 573-441-1770 or sbrandes@moumethodist.org

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