WCM

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"Connecting Women in Purpose and Vision"

West Coast / San Diego Connection Dinner Registration

Thursday, April 2, 2009

Dinner and Program:

 $35 for Guests, $30 for WCM Members

($40 for everyone after March 30)

* Required Fields

Enter # Program Tickets *:

      Guests ($35)       WCM Members ($30)
First Name*:
Last Name*:

Title*:
Organization*:
Street Address*:
Address (line 2):
City*:
State*:
Zip Code (5 digit)*

Contact Phone#

(with area code):

 ()                 -                 
E-mail*:  

Once you complete the above information, click on "Submit Form" button and you will be taken to the online PayPal payment center.  Registration is not complete until payment is received.  Please print your PayPal receipt as your ticket for the Connection Dinner.  Tickets are not refundable, but may be transferred to another person.

     

For mail-in registrations

Fill in the above form, print the form and enclose your check made payable to:

Women in Christian Media

 

Mail to arrive before the deadline to:

Women in Christian Media

P.O. Box 571566

Dallas, TX 75357