MBU Equipt: Church Workers Conference

Registration Information:

Attendee Registration | $30 (includes lunch)

Sponsor Registration | $100

Registration includes a display table, an advertisement in the conference booklet, and lunch. Please submit artwork for booklet & PPT to ExecutiveOffice@mbu.edu by Monday, September 7. Dimension specs:

no bleed or crops necessary
1/2 page - 4.75x3.75 (horizontal)
1/4 page - 4.75x1.75 (horizontal)
full page - 4.75x7.5 (portrait)

First Name

Last Name

Mailing Address

City

State

Zip

Non-US Address

Province/District

Country

Phone

e-Mail

Church Name w/ City & State

Are you a full-time, on-campus MBU Student?

YesNo

Student ID Number

Are you a sponsor?

Yes ($100)No

Organization Name

Is a spouse attending?

Yes ($30)No

Spouse's First Name

Spouse's Last Name

Total Payment Amount

HIDDEN - Total Amount

Payment Information

Billing Address

Street

City

State

Zip/Postal Code

Province/District

Country

NOTE: There are no transaction/convenience fees for credit card payments.

Payment Method

Credit CardeCheck (USA Only)

Credit Card Details

Name on Card

Card Number

CVV

Expiration Month

Expiration Year

NOTE: You have chosen a non-USA billing address and the eCheck payment method. Your eCheck payment will not be able to be processed from a non-USA bank account.

Bank Account Details

Account Holder Name

Bank Name

Account Type

Account Number

Routing Number

Confirm Account Number

Confirm Routing Number

Account Numbers Match?

Routing Numbers Match?

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Contact Information