Registration Form

Complete The Form below to register

Living in Color: Equipping Leaders to Serve in a Diverse World

November 7-8, 2014 at Geneva College

(Early Bird Registration ends October 17, 2014) View Pricing











Note: The options above will be selected during the payment process


Prefix:
First Name: *
Last Name: *
Preferred Name:
   
Address: *
City: *
State: *
Zip Code: *
   
Email: *
Phone: * (example: 555-555-5555)
   
Organization/
School /Church:
 

Special Needs/Food Allergies
Please specify if you have any accessibility needs, food allergies, etc.

 

How did you hear about the conference?

   

Are you an Alumni of Geneva College?

   

Are you a college student?


   

Ethnicity
(example: Caucasian, African American)

   

If you are registering a group, list the names of additional attendees in your group: (optional)

Note: During the payment process you will choose type of registration and number of people, etc.

 

GENEVA COLLEGE | 3200 College Avenue Beaver Falls, PA 15010 • 800-847-8255 • web@geneva.edu