World Missions Summit
Registration Form
please complete, copy & submit - we will be expecting you

 fname  lname

Gendermalefemale    Age       Birthdate
                                        (if under the age of 18 years - please include a medical release from parent/guardian)

Mailing Address: (include city, st & zip)
City   State   ZIP

Phone #        Do you have facebook?

 E-address  

Group or Campus

Where would you like to meet the busses? TulsaOklahoma City

Housing Options - 4 per room (if you have different needs, please call)

Roommate Choice(s) - (same gender unless married /you're roommates must request you also)
1)
2)
3)
Special needs, questions or comments (ie handicap access, need a roommate, etc)

 Pay $100 deposit: (we are working on online payment but until that is completed)
Please copy this form and include your $100 deposit and mail to:
Chi Alpha/WMS; PO Box 2777; Norman, OK  73070
make checks payable to Oklahoma Chi Alpha Campus Ministries
(The next $100 payment is due November 21.  The balance will be due December 19.  Your first deposit reserves your room and transportation.  The second deposit is for your registration.)

        After copying this form - click the submit icon and we will be receiving your information so we can save a place for you.  Don't forget that registration is not complete until you have mailed the deposit! Thanks for your help and hopefully we will have online payment available soon!