2019 Annual Meeting Registration
Contact Information:
Last Name *
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First Name *
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Street Address 1 *
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Street Address 2
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City *
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State *
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Zip *
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Country
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Email *
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Mobile Phone Number *
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Work Phone Number
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Name to Appear on Badge
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Affiliation *
Name of Study Center, Partner Organization or other affiliation *
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If staff, what is your position title?
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Additional Information:
Roommate? If you would like to request a roommate, please enter their name below.
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Do you need transportation to/from O'Hare airport? (Unfortunately, we cannot provide transportation to/from Midway airport.) *
Do you have any dietary restrictions? If so, please explain.
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Payment:
Please note that all registrations are non-refundable after June 30. To pay your registration fee online, scroll down to the bottom of the web page and click on the PayPal button. The registration fee is per person and includes lodging and 5 meals.
Select from the drop-down menu below the payment options that applies to to you. *
Form of payment *
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This form was created inside of Consortium of Christian Study Centers.