Personal Information
(One person per form)
First Name*   Last Name*  
(Type your name as you want it to appear on your badge.)
Home Address*
City*   State*    Zip*  
Country (missionary only)
Home Phone  Email  
Cell Phone
Church You Attend
Church Location: City   State  
* Required information
Registration
National Association
All voting delegates must be members
in good standing of a FWB church.

Voting Delegates:
National Board/Commission Member
Ordained Minister
Ordained Deacon
State Delegate
Local Church Delegate – $100

Non-Voting Attendees:
Licensed Minister
Attendee (includes infants and toddlers)

Women Nationally Active for Christ
WNAC Information: www.wnac.org
Voting Delegates:
National Officer
State President
State Field Worker
State Delegate
Local WNAC Delegate – $10

Non-Voting Attendees:
Attendee
Missionary

National Youth Conference
NYC Information: www.fwbnyc.com
Select One:

Preschool:
Ages 3-5 – $25*
(attending preschool worship)
Ages 0-5 – NO FEE
(NOT attending preschool worship)
Students:
Grades 1-3 – $25*
Grades 4-6 – $25*
Grades 7-12 – $25*
College Age/Adults:
Attending NYC Events – $10
(Fee covers attendance to NYC worship services, competition, activities, etc.)

*On-site registration – $35