HOUSE OF GOD, INC
90th Annual General Convocation - Guest Clergy Registration Form
Personal Information
Title:
First Name:
Last Name:
Address:
City:
State:
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip:
Phone Number:
Email Address:
Church Name:
Church Address:
Pastor's Name:
I am a guest of:
Date of Arrival
Select Date:
Please Select
Sunday, July 19th
Monday, July 20th
Tuesday, July 21st
Wednesday, July 22nd
Thursday, July 23rd
Friday, July 24th
Saturday, July 25th
Other family members in attendance from the same household (16 years and up)
Title
First Name
Last Name
Age
Person #1:
Person #2:
Person #3:
Other family members in attendance from the same household (15 years and down)
First Name
Last Name
Age
Person #1:
Person #2:
Person #3:
Special accommodations
Interpreter
Sabbath diabetic meal ticket