Registration for ALC 2019

Thank you for your interest in registering for ALC2019!

This is the registration form for the Assembly Leadership Conference (ALC) 2019 that is organised by the Christian Brethren Secretariat Malaysia (CBSM) biennial. The 2019 edition of the ALC is themed "You Are My Witness - Engaging the Community", following on from the wake-up call of the 2017 "You are My Witness - Challenges of the Malaysian Assembly" theme.

If you are a concerned believer attending any brethren assemblies in Malaysia, you are invited to attend ALC2019.
You do not need to be holding any leadership position to qualify to attend.

Date : 27 - 30 November, 2019 (Wed - Sat)

VENUE : Hotel Excelsior, IPOH, PERAK
FEES : Per Person RM390 (for TWIN Sharing) ; RM640 (for SINGLE occupancy)
(Free for those under 6 years old)
Email address *
ASSEMBLY LEADERSHIP CONFERENCE 2019
Title *
Name *
Your answer
Contact Phone Number (Please key in with prefix +60 follow my your mobile number with no "-" and spaces; eg. +60191234567) *
Your answer
Emergency Contact Name
Your answer
Emergency Contact Phone Number (Please key in with prefix +60 follow my your mobile number with no "-" and spaces; eg. +60191234567)
Your answer
Age *
Gender *
Address
Your answer
Full Name of Church (Please key in with ALL CAPITAL LETTERS) *
Your answer
Position
Ministry Involvement (Please Tick all that Applies)
Profession & Industry currently involved in
Your answer
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