Preferred Mailing Address

City State Zip

County Congregation or group affiliation

Home/Cell Telephone Office Telephone

E-mail

Check for Vegetarian Meal:

Registration Fees (including arrival snacks and lunch):

$23.00
$14.00 for students

Payment Options:

Check: Amount: Make payable to NC Council of Churches, Memo: Critical Issues
Mail to: NC Council of Churches, 1307 Glenwood Ave., Ste. 156, Raleigh, NC 27605

Credit Card via Paypal: Please click here to make PayPal payment. Then return to this form to complete your registration.

All of Greensboro College’s buildings are accessible. If your mobility is such that you could use assistance in getting from one building to another, please check here

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**Please note that payment should be remitted in addition to the submission of this form.