The Well - Online Registration Form


This form will be submitted to Harvest Conferences via email. To mail a form to Harvest, please use the: Printable Registration form (PDF format).

Choose Location/Date: Mt Vernon, IL - Monday, October 6 (evening seminar)
Belleville, IL - Tuesday, October 7 (morning seminar)
Clinton, IL - Tuesday, October 7 (evening seminar)
Bloomington, IL - Wednesday, October 8 (morning seminar)
Peoria, IL - Thursday, October 9 (morning seminar)
Jacksonville, IL - Thursday, October 9 (evening seminar)
 
Name:
Church:
Address
Phone:
Email:
Number Attending:
Method of Payment: Check
VISA
MasterCard

If paying by Check, please make the check out to: Harvest Ministry Teams

 

© 2008 Harvest Ministry Teams