Registration Form

Participant Name

Address

Cell Phone Number

Grade level taught (plan to teach in 2022-23)

Shirt Size

School Information

School Name

Address

Phone Number

Person Responsible for Payment (if not participant or school)

Name

Address

Phone Number

Registration Options

Training, housing, meals, and resources
Training and resources only

If possible I would like to room with:

Payment Options

Training, housing, meals, and resources - $625
Training and resources only - $450
Deposit only - $100

Payment form (aside from deposit)

Card
Check (mail to Education Department)

Non-refundable deposit of $100 must accompany this form or be mailed immediately. Without the deposit, a reservation will not be made. The rest of the payment is due May 31, 2022. All payments are made to FBBC.

Mail checks to: Faith Baptist Bible College, 1900 NW 4th Street, Ankeny, IA 50023
Email: [email protected] | Phone: (515) 964-0601 | www.faith.edu

Billing Information

Name

I am representing an organization

Credit Card

Visa
Mastercard
Discover

Address

Mobile Phone Number

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