REGISTRATION FORM | lavernewebermin

REGISTRATION FORM: (please make copies as needed)

NAME (please print) _________________________________________

Address____________________________________________________

__________________________________________________________

Phone Number______________________________________________

Email______________________________________________________

First time registration __ Returning Alumni registration __ (Check one)

Registration with Leadership Manual ($45.00) _____

Registration for those who have Leadership Manual ($25.00) _____

Church____________________________________________________

Mail with check to: Rev. Laverne Weber

Faith Community Assembly of God

3000 Freemansburg Ave.

Easton, Pa 18045

For more information:

Telephone: 610-597-4059

Print out the file below and mail it in.