PET Youth Triennium Registration
Event Timing: July 16th-20th, 2019
Purdue University
Event Address: 610 Purdue Mall, West Lafayette, IN 47907
Contact: (865) 981-8180 carrie.niceley@maryvillecollege.edu or youthcommittee@presbyteryeasttn.org
Email address *
Presbytery *
Participant First Name *
Your answer
Participant Last Name *
Your answer
Badge Name *
Your answer
Identifying Gender *
Birth date *
MM
/
DD
/
YYYY
Role *
Special Needs and/or Dietary Restrictions
Your answer
Applicant Cell (that can be reached during the retreat) *
Your answer
Applicant Email *
Your answer
T-shirt Size *
Assigned Roommate (Not required)
Your answer
Home Church *
Your answer
Home Church City/Town *
Your answer
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