site mapcontact
 
 REGISTRATION FOR GEMS WINTER CONFERENCE-2011 
Please complete the following information for Registration to the GEMS Winter Conference which will be held on Saturday, December 3, 2011, from 8:00 a.m. to 3:00 p.m., at the Perry Home, an annex building next to the United Methodist Church, 3 E. Wright St., Pensacola, FL. For additional information, contact Sonya Culliver at 850-549-7303.

First Name:
 *
Middle Initial (If no MI enter NMN)
 *
Last Name:
 *
Address:
 *
City:
 *
State:
 *
Zip Code:
 *
Home Phone No:
 *
Cell Phone No:
 *
Email Address:
 *
Age:
 *
School Attending:
 *
Grade in School:
 *
Parents Name:
 *
Parents Address:
 *
Parents City State Zip Code:
 *
Parents Email Address:
 *
Parents Home Phone No:
 *
Parents Cell Phone No:
 *
Please answer yes or no to the following three questions:
Does your parent know you are registering for this conference?
 *
Do you need transportation to and from the conference?
 *
All public media will have access to the conference? Do we have your permission to release your photo to the media?
 *
COMMENTS
After you submit the Registration Form please go to the PRE AND POST QUESTIONNAIRE FORM tab and complete and submit the questionnaire.
Security code:
 *
Do not enter anything in this field:

* indicates a required field
 

Hours of Operation:
Monday-Thursday, 9:00 a.m to 2:00 p.m.

Mailing Address:
Milk and Honey Outreach Ministries
P.O. Box 1443
Pensacola, FL  32597-1443

Office Address:
Milk and Honey Outreach Ministries
31 E. Wright St.
Pensacola, FL  32501-1443

Phone:  (850) 469-8788/(850) 469-1194
Fax:  (850) 432-5749
Email:  sculliver@bellsouth.net
           wgulley@bellsouth.net
           vasantoni@bellsouth.net

Web address:  http://milkandhoneyoutreach.org

 

 

This Website Designed using the
iBuilt Website Builder