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, resources, and housing
Training and resources only

If possible I would like to room with:

Required deposit amount

Deposit - $100

Payment form (aside from deposit)

Card
Check (mail to Education Department)

Payment Options after the deposit (payments can be made later or a check can be sent)

Training, resources, and housing - $635
Training and resources - $535

Coupon Code (does not apply to deposit)

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, 2023. All payments are made to FBBC.

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

Almost done. Where should we send the confirmation?

Name

I am representing an organization

Mobile Phone Number

Event Registration Software by RegFox