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Registration

Your registration is not complete until you have filled out the form below AND entered your credit card number in the secure payment processing page that follows.

This form may be used to register you and your spouse, plus three additional registrants (and spouses, if registering). If there are more in your group please submit this form a second time.

If you are submitting a second registration form, you do not need to enter all of your information again. Please enter only your name, and in the Additional Registrants section, please enter the group name and continue adding your registrant information.

After filling out the registration form, press the "Register Me For The Conference" button at the bottom. This will take you to the payment processing pages, where you can complete your registration by credit card.

  • If you would like to register by mail or fax:
    • To register by mail, print out this form and mail it with your check, payable to:
      The King's College and Seminary
      Autumn Leadership Conference
      14800 Sherman Way, Van Nuys, CA 91405-2233
    • To register by fax, print out this form and fax it to: 818-779-5511
  • If you would like to register by phone, call 888-779-8050
Registration
First Name
 
Ministry Title
Last Name
 
Spouse Name
Ministry Title
Home Address
   Apt.#
City
  
State
  
Zip/Postal Code
  
Country
Telephone (home)
  
Fax
E-mail
  
Confirm E-mail
  
Church/Organization
Single Registration: Advance to end of form. Continue for multiple registrations.
Additional Registrants
Group Name
Additional Registrant 1
First Name
Ministry Title
Last Name
Spouse Name
Ministry Title
Home Address
 Apt.#
City
State
Zip/Postal Code
Country
Telephone (home)
E-mail
Confirm E-mail
Additional Registrant 2
First Name
Ministry Title
Last Name
Spouse Name
Ministry Title
Home Address
 Apt.#
City
State
Zip/Postal Code
Country
Telephone (home)
E-mail
Confirm E-mail
Additional Registrant 3
First Name
Ministry Title
Last Name
Spouse Name
Ministry Title
Home Address
 Apt.#
City
State
Zip/Postal Code
Country
Telephone (home)
E-mail
Confirm E-mail

Pre-Registration $199 per person (Expires 11/05/08)
Married Couples Rate! $300 per married couple (Expires 11/05/08)
 Group Registration (four or more at the same time) $179 per person
After November 5, registration will be $249 individual;
$349 per married couple at the door.

Registrations are transferable, but not refundable.
Registration confirmation will be sent by e-mail.