Are you traveling alone?     YES     NO    

If No, Who are you traveling with?     spouse      pastor/associate      other

If No, Name of individual you are traveling with:    

Name of Church:

Are you the Senior Pastor?     YES   NO     

If No, What is your position?

Have you attended a previous RCCM World Ministry Conference?     YES     NO     Year(s):

Upon acceptance of this registration by RCCM, you will be sent an invitation letter which will allow you to apply to the US Embassy in your country for a visitors VISA. The invitation letter will state that RCCM will be responsible for your food, and accomadations from Saturday, April 29, 2006 until Thursday, May 3, 2006 at 12pm.
Are you staying in the US after May 3, 2006, or are you arriving in the US before April 29, 2006?     
YES     NO

If yes, you must provide a detailed itenerary of your visit. Please describe below:

If your registration is approved, and your VISA is granted by the US embassy, will you use your entry into the US for its intended purpose, to attend the RCCM World Ministry Conference 2006?    
YES     NO

The applicable adminisration fee is as follows:
For RCCM crediential holders: $40 by close of registration, November 15, 2005.
For non RCCM crediential holders, $50 by close of registration, November 15, 2005.
RCCM accepts all major credits card, or you may send a check or Money Order to:
World Ministry Conference 2006
3177 Lyell Rd. Rochester, New York, 14606. USA.

If you wish to pay by credit card, you may do so securely by clicking the appropriate image below: PLEASE NOTE: If you are paying for a registrant other than yourself, please specify both your name (the credit card holder), and the registrant's name in the "comments" box below.

Please select one:
I have paid by credit card           I will pay by check

Please enter any additional comments below:

PLEASE NOTE A CHANGE IN WMC REGISTRATION POLICY:
Registrations will not be finalized until a copy of your air ticket and vistors visa have been filed with RCCM's WMC registrations personnel. This information can be sent to the address above.