Midwest Ministers’ Retreat Registration Register for the Midwest Ministers' RetreatWe will not sell or otherwise disclose to third parties the information you provide via this registration form. Providing contact information will enable us to send you information about our next event or contact you should we have questions about your registration.Name* First Last Address* Street Address Address Line 2 City AAAEAKALAPARASAZCACOCTDCDEFLFMGAGUHIIAIDILINKSKYLAMAMDMEMHMIMNMOMPMSMTNCNDNENHNJNMNVNYOHOKORPAPRPWRISCSDTNTXUTVAVIVTWAWIWVWY State ZIP Code Phone*Email Church* Number of Years in MinistryI PLAN ON BRINGING A FIRST TIME ATTENDER I PLAN ON BRINGING A FIRST TIME ATTENDER Note: A separate registration form must be submitted for each individual.Registration optionsFull Registration - $30 ($20 for spouse)REGISTRATION FOR THE MIDWEST MINISTERS' RETREAT & SUMMIT* Full Registration Include Spouse Yes No Total $0.00 Payment Type* Pay with Credit Card Pay with PayPal Pay by Check Please mail your check made payable to Lincoln Christian University to Lincoln Christian University, Attn: Midwest Ministers' Retreat, 100 Campus View Drive, Lincoln, IL 62656Credit Card* American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Month010203040506070809101112 Year20232024202520262027202820292030203120322033203420352036203720382039204020412042 Expiration Date Security Code Cardholder Name CAPTCHA