American Baptist Churches of Pennsylvania and Delaware

2015 Conference Registration Page


Please fill out the entire form. Once you select "Submit" the completed form will be emailed to Kevin Walden, Denise Veselicky and Caryl Casey. You will return to a thank you page that includes a link to our on-line payment feature. If you choose not to submit an on-line payment you will be expected to make payment by check prior to coming to the conference. If you make a partial payment you will be asked to complete your payment at the conference. 

 

 

Pastoral Leader, Congregation Member or ACTS student?
Full Conference or Saturday Only or Saturday Webinar?
Title
First Name
*
Middle Name
 *
Last Name
 *
Street Address
 *
Street Address 2
City
 *
State
 *
Zip Code
 *
Email Address
*
Home Phone # (with area code)
 *
Cellular Phone # (with area code)
 *
Church Membership
 


Please validate by entering the text from the image below into the provided field.
YOU WILL THEN BE ABLE TO CLICK THE SEND BUTTON TO SUBMIT YOUR FORM.