Global Leadership Summit 2017 Registration
Please use this form to register. Payment must be made by mail via check.

The Global Leadership Summit will be held from 9:30am-5:30pm each day at Shelter Rock Church in Syosset, NY.
Information about bringing / purchasing your lunch each day will follow for those who have registered.

Please contact Rev. David Czeisel at for more information or to obtain a receipt.

First Name *
Your answer
Last Name *
Your answer
Church / Organization *
Your answer
Please indicate your church affiliation: *
Note: United Methodists from the Long Island East District or Long Island West District receive a special rate, due to a multi-district scholarship. All rates go up by $30 after June 20th.
Street Address *
Your answer
City *
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State *
Your answer
Zip *
Your answer
Phone (Cell Preferred) *
Your answer
Email Address *
Note: By submitting your email address, you give us permission to contact you about future Global Leadership Summits.
Your answer
Is this your first time attending the Global Leadership Summit? *
By checking below, I agree that I will use the skills and insights that I glean from the Global Leadership Summit in my church and life. *
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