Building Healthy Churches - Workshop Registration Form

workshop topic

Workshop title: ______________________________________________________________

Date(s) desired: _____________________________________________________________

registration information

Name of Person making reservation: ____________________________________________

Title: _____________________________________________________________________

Church: ___________________________________________________________________

Address: __________________________________________________________________

Phone: ___________________________________________________________________

email: ____________________________________________________________________

special needs/questions

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

registration fee

Enclose a nonrefundable check for $100 payable to "Building Healthy Churches" to reserve
your workshop. A member of our staff will contact you to finalize arrangements. Please
mail this form and your check to:

                                                    Building Healthy Churches
                                                    P.O. Box 482296
                                                    Kansas City, MO 64148

(Print this form and mail to the address below)

registration form

Building Healthy Churches Box 482296 Kansas City, MO 64148 (816) 547-7887 www.buildinghealthychurches.com