Dwelling in the Word Registration, Augustana Lutheran Church

Dwelling in the Word

Saturday, April 27, 2013, 9 a.m.–3 p.m.
Fellowship Hall, Augustana Lutheran Church

Registration of $30 payable to Augustana Lutheran Church includes the workshop, lunch, snacks, child care, and Dwelling in the Word pocket handbook.

Registration

First Participant

Name

Prefix

First

Last

Suffix

Address

Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country

Email

Phone

###

####

Congregation Affiliation:

Second Participant

Name

Prefix

First

Last

Suffix

Email

Phone

###

####

Congregation Affiliation:

If you require child care, please indicate the names and ages of your children to the right. (Children will join their parents for lunch.)

If you have particular dietary allergies or needs, please indicate that here.

Registration

$30 per participant *

Dollars

Cents

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