[ Registro - En Espaņol ]

First Name:
Last Name:

Email:
Website: (Optional)

Referred by: (Optional)

City:   State:  


Hospitality Needs:

Housing:
I am willing to sleep on the floor of the church building (We do have showers!)
I am interested in the POSSIBILITY of housing with a family from a local church
(We will be in touch later to work this out...)
I will not need housing during the conference

Airport Transportation:
I will need a ride to and from the airport
I will not need a ride to and from the airport

Meals:
I would prefer non-vegetarian meals
I would prefer vegetarian meals
Other special dietary needs:

Childcare (Saturday - Infants through 5th grade):
I will not need childcare.
One child $5
Family (More than 1 child) $10 - Number of kids:


Payment:

COST:    $25 Includes materials, meals and housing (if needed)

Form of Payment:
Email me with instructions for making an online Credit Card payment ($2 processing fee )
I will be sending a check or money order.
      Please send payment -- made out to ENGLEWOOD COMMUNITY DEVELOPMENT CORP. -- Promptly to:
         NO LONGER STRANGERS CONFERENCE
          Englewood Christian Church
          57 N. Rural St
          Indianapolis, IN 46201




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