2010 National Deaf Christian Workshop

  

 

Register


Please fill out the registration form completely to help us better serve you.
You are required to enter your email address 2 times. This is done for security purposes.

Required fields are marked with an asterisk (*).


  Personal Information  
 
First Name:*

Comments / Special Needs:

Last Name:*
  Deaf* --------- Will Interpret
Hearing*

  Spouse Information  
 
First Name:

Comments / Special Needs:

Last Name:
  Deaf --------- Will Interpret
Hearing

  Your Address  
 
Address 1:* Home Phone:
Address 2: Fax:
City:* Cell Phone:
State:* Pager:
Zip: Country:
Email:*
Email Again:*

Note: If you do not have an email address, you can go to Yahoo Mail or
Google Mail and register for a free email account. Then use that email address
to register with.
Web Site:

May we put your email address on the workshop address list? Yes --- No
May we put your pager number/address on the workshop address list? Yes --- No
May we put your web site address on the workshop address list? Yes --- No

What do you want to get out of this year's workshop?

  Children Information  
 
Child 1 Name:

Comments / Special Needs:

  Deaf --------- Age:
Hearing
Child 2 Name:

Comments / Special Needs:

  Deaf --------- Age:
Hearing
Child 3 Name:

Comments / Special Needs:

  Deaf --------- Age:
Hearing
Child 4 Name:

Comments / Special Needs:

  Deaf --------- Age:
Hearing
Child 5 Name:

Comments / Special Needs:

  Deaf --------- Age:
Hearing
Child 6 Name:

Comments / Special Needs:

  Deaf --------- Age:
Hearing

  Church Information  
 
Home Church:
Address:    
Deaf Minister:    
Office Phone:

   
Fax:    
Email:
Church Web Site:

  Housing Information  
 

Note: Limited housing will be available at the Faulkner University dormatories. This housing will be provided for this year's workshop on a first come, first served basis. The cost will be $20 per person per night.

In addition, 15 RV hookups will also be available on a first come, first served basis at $100 each hookup for the week.

If you want housing or an RV hookup, please click the appropriate radio button below. Otherwise, please consult the list of hotels here and enter your selection below. If you don't know where you will be staying at this time, you may return later and update your information by logging in using your user ID and password.

Please provide information on where you will be staying while at the workshop:
Select Housing Type: Hotel or Other
Dormatory (Faulkner) -- $20 per person per night  --  How many nights?  nights
RV (Faulkner) -- $100 per hookup for the week
Name of Hotel or Friend:
Address:    
Phone:    
Fax:

   
Special Needs:    

  Travel Information  
 

We can provide transportation between the Workshop at Faulkner University and the Montgomery Airport for those who are arriving/departing Montgomery.
Arrival Date: Flight Information:
Departure Date: Flight Information:
Transportation Needs:

  Other Information  
 

There will be a fund raising dinner on Wednesday, June 23rd, in the Bible building rotunda. The cost will be $30 a plate, and seats are limited. The proceeds will benefit deaf christian camps. The dinner speaker will be announced.

    
Please plan to attend the fund-raiser dinner (more information...) How many will be attending from your family? How many adults?
How many children?

 
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