Group Registration Form | Full Strength Network

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Your Group/District/Region Name

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Group Price

Is this registration for yourself or for your group?

Your Contact Information

Name*

First Last

Email*

Phone*

Name*

First Last

Email*

Phone*

Church Name*

Name

First Last

Email

Phone

Group Name

Please complete the following information for each new member. To add additional people, click the

after each individual's info row below.

First Name	Last Name	Email	Mobile	Church Name	Position

What email address should we send the receipt to?

How would you prefer to pay?

Enter the quantity of members listed above.

Enter a 1 if only enrolling yourself.

Price: $149.00

Total

$0.00

Credit Card

Card Details

Cardholder Name

Card Billing Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Where should we send the invoice?

Street Address Address Line 2 City State ZIP Code