CHURCH PLANTING ASSESSMENT CENTER

Name *

First Name

Last Name

Mobile Phone *

(###)

###

####

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

I am attending: *

As a Candidate to be Assessed

As an Assessor

Assessment Director Training Only

Do you need hotel accomodations? *

Yes, Please make hotel accommodations for me at the group hotel.

No, I live locally or will make my own arrangements for lodging

Transportation *

How will you travel to the assessment and would a shuttle from the hotel to the assessment center be helpful?

Fly

Drive

Yes, I'd like to use a shuttle from the group hotel

I will be handling my own accommodations and transportation to and from the event each day.

How do you plan to pay the registration fee *

I will pay online as soon as I finish this registration form.

My district or local church is covering the entire cost of my registration fee (Please include details in the notes below).

My district or local church is covering a portion of the cost of my registration fee (Please include details in the notes below).

As a part of the assessor team, my lodging and meals are covered.