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Assemblies of God Northern California and Nevada District

2008 Women's Ministries Fall Retreat: Registration Details

To register for the 2008 Women's Ministries Fall Retreat, please complete the following form. When you click the Submit button, you will be taken to a page which will enable you to add various options to our PayPal shopping cart. If you have any problems, please don't hesitate to .

It is very important that the details you enter here (name, street address, etc.) match the information you enter into the PayPal shopping cart on subsequent pages. This will allow us to match your registration details with your payment.

Name:

Street Address:

City:       State:       Zip Code:
         

Phone:

Email:

Home Church:

Church Address:

Accommodation Type"
(standard rooms are already full)
Deluxe $280
Economy $200
Offsite $140

Specific Lodging Preference (dorm name, cabin name, etc.):

Number in Room (single occupancy charge is an additional $35 per night):

List Roomates

Roommate 1:

Roommate 2:

Roommate 3:

Roommate 4: