Warning: mysql_fetch_assoc(): supplied argument is not a valid MySQL result resource in /usr/local/lib/php/SU/1934/controller/su_survey.php on line 636
Firstname: *
Lastname: *
Address: *
City: *
State: *
Zip: *
Phone Number: *
Email Address: *
Please select the registration option from the choices below.
Registration Options:  Full Weekend $50;   Sabbath Only $20;   Church Service $0;  
$50 option (6 meals, dorm lodging upon availability, all events and breakouts.) $20 Option (2 meals on Sabbath and all events and breakouts on Sabbath) No Charge (All are welcome to attend the church service on Sabbath.)
Age at the time of conference: *
Participants under the age of 18 must be accompanied by a chaperone.
Type of Attendee:  Student;   Adult;   Chaperone;  
If you are a chaperone, write the names of the people in your group.
Attendees in Group:
Fields marked with an * are required.


6433 US Highway 11 Lumberton, MS 39455 • (601-794-8561)
(Fax 601-794-8881)

Legal Notice & Privacy Policy  
  SiteMap.   Provided by the North American Division and AdventistSchoolConnect.org © 2002-2010.   User Login / Customize.