Conference Registration Form

There are two was to register for the conference
    (1) Click here for a Printable Form and mail it to
    (2) Register on-line

We encourage and prefer you to register on-line using the form below.

If you use the electronic form below, please note that fields marked with an asterisk (*) are required. When you click on the "SUBMIT" button at the bottom, your information will be recorded and an email confirmation sent to you. You will be redirected to another page. If you have any questions, please contact Terry Palmer.

First Name:*


  Gender:*:*

Ward or Branch

Emergency C Emergency Contact #

Please check the conference events you plan to attend:*







I wish to donate $20 to the conference and pay by
    PayPal
    Check (Payable to Seneca Maryland Stake)

        Mail to: JITT, c/o LJ Boynton,
                    107 Wading Duck Way
                    Stephenson, VA 22656
    At Door

Please let us know if you have any Dietary Restrictions so that we can make sure that we have food for you.

 

Would you be available and willing to help with set-up and/or clean-up for one or more events at the conference?*

Please type what you see below:

PLEASE REVIEW THE INFORMATION YOU'VE ENTERED CAREFULLY BEFORE SUBMITTING.


PLEASE HIT THE "SUBMIT" BUTTON ONLY ONCE.
PLEASE DO NOT HIT THE BACK ARROW...YOU WILL BE REGISTERED TWICE

 

This Conference is for Single Adults Only
*** All Divorces must be final ****

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Click here to contact the webmaster.