Register for the
BFC 2010 Ministerial Convention

October 5-6, 2010

Pastor's First Name:
Wife's First Name:		Check if wife is attending
Last Name:

Contact Information
Address 1:
Address 2:
City, State, Zip:
Phone:
Email Address:

Church Information
Church Name:
Other Church:

Additional Information
Special Notes: (please enter any special needs you wish to communicate)

Payment Information
		Payment may be made now or at check-in at Pinebrook. To pay be check now: BFC Ministerial Convention Committee c/o Whitehall BFC 3300 7th Street Whitehall, PA 18052 To pay at check-in: Bring cash, check, or credit card to Pinebrook and pay at the Guest Services Building.