Registration Form

Return this completed Registration Form along with your check for $109.50 to:

North Phoenix Baptist Church

Attn: Jeanette Cluff

5757 N. Central Avenue

Phoenix, AZ 85012

85206

Checks should be made out to PRECEPT MINISTRIES (please don’t send cash)

Personal Information: Please fill out completely.

Name ___________________________________

Name called by__________________________

Address ___________________________________

City ___________________________________

State ________________________

Zip _________________

Home Phone ___________________________

Work Phone ___________________________

e-mail address ___________________________

Registration deadline: February 9, 2012

Workshop Dates: February 24-25, 2012

Prerequisite Information: None Required