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

www.laverneweberministries.com

Email: laverne.weber12@gmail.com

Print out the file below and mail it in.