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Register 
23rd Annual Conference
March 19-20, 2009
Elkhart, Indiana

If paying by check, please select the Print Icon (top right corner) to print out this form and mail it in with your check.

If you are going to pay online, please fill out the form and then select "Submit Form". Your form will be submitted and you will be taken to the online payment.

 

Mr. Mrs. Miss Other             Name: required field  

Address: required field

City: required field   State: required field    Zip code: required field 

Telephone: required field

E-mail: required field

Cell:

Business Information

Occupation: required field     

Affilation:   

     My business address is the same as the above

Address: 

City:       State:       Zip code: 

Phone:  

Select one track:  Introductory Advanced required field

If you selected "Advanced", please give a brief statement identifying any previous introduction to the American Christian Philosophy of History, Government, and Education.

Early Registration (Paid by February 19, 2009)    $80.00*
Final Registration (Paid after February 19, 2009)    $90.00*

        required field = Required

* $40.00 of Registration Fee is non-refundable. The balance will be refunded if Pilgrim Institute is notified 72 hours prior to Conference.
 
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