REGISTRATION FORM
REGISTRATION FORM Co-Sponsored by Texas Baptists and Wayland Baptist University
February 23, 2017- Wayland Baptist University, San Antonio, Texas February 28, 2017-Wayland Baptist University, Plainview, Texas CANCELLATION POLICY Refunds requested by February 20 will be returned less $10 administrative fee. There will be no refunds after February 20. Which event are you attending? San Antonio______ West Texas (Plainview) ______ If more than one person is registering please list the names and the following contact information on a separate page:
Name_______________________________________Email: _____________________________________ Cell Phone: _____________________________________________________________________________ Church Name______________________________________Ministry Position: _______________________ Church Address: _________________________________________________________________________ Church City: __________________________________________Church State, Zip: ___________________ Church Phone: _______________________Church Email: _______________________________________ Cost of Worship Summit is $25 per person which includes lunch.
PAYMENT INFORMATION AMOUNT ENCLOSED: Number of Registrants ____ x $25 = ________
□ Paying by check: Make check payable to Baptist Executive Board & mail with registration form to: Texas Baptists Finance & Accounting - Worship Summit 7557 Rambler Rd Suite 1100 Dallas, Texas 75231-2388
□ Paying by Credit Card: Type of Card: □ MasterCard
□ Visa
Amount to charge: $_________________
□ Discover Card
□ American Express
Exp. Date (MM/YY): _________________
Name as appears on card: (Please Print) ________________________________________________________ Card #: ______________________________________________ Card Security Code (3 Digit #): __________ Credit Card Holder’s Billing Address/City/State/Zip: ______________________________________________ _________________________________________________________________________________________ I authorize these charges to be billed to my credit card: ___________________________________________ Cardholder Signature For more information: www.texasbaptists.org/music CONTACT TOM TILLMAN at 828-5246 or [email protected] or DAN TURNER at 806-930-4411 or [email protected]
February 23, 2017- Wayland Baptist University, San Antonio, Texas February 28, 2017-Wayland Baptist University, Plainview, Texas CANCELLATION POLICY Refunds requested by February 20 will be returned less $10 administrative fee. There will be no refunds after February 20. Which event are you attending? San Antonio______ West Texas (Plainview) ______ If more than one person is registering please list the names and the following contact information on a separate page:
Name_______________________________________Email: _____________________________________ Cell Phone: _____________________________________________________________________________ Church Name______________________________________Ministry Position: _______________________ Church Address: _________________________________________________________________________ Church City: __________________________________________Church State, Zip: ___________________ Church Phone: _______________________Church Email: _______________________________________ Cost of Worship Summit is $25 per person which includes lunch.
PAYMENT INFORMATION AMOUNT ENCLOSED: Number of Registrants ____ x $25 = ________
□ Paying by check: Make check payable to Baptist Executive Board & mail with registration form to: Texas Baptists Finance & Accounting - Worship Summit 7557 Rambler Rd Suite 1100 Dallas, Texas 75231-2388
□ Paying by Credit Card: Type of Card: □ MasterCard
□ Visa
Amount to charge: $_________________
□ Discover Card
□ American Express
Exp. Date (MM/YY): _________________
Name as appears on card: (Please Print) ________________________________________________________ Card #: ______________________________________________ Card Security Code (3 Digit #): __________ Credit Card Holder’s Billing Address/City/State/Zip: ______________________________________________ _________________________________________________________________________________________ I authorize these charges to be billed to my credit card: ___________________________________________ Cardholder Signature For more information: www.texasbaptists.org/music CONTACT TOM TILLMAN at 828-5246 or [email protected] or DAN TURNER at 806-930-4411 or [email protected]
