This form is for senior pastors only. If you are not a senior pastor, please click here

 

       
Last Name:    
First Name:    
Address:    
City:    
State/Region:    
Country:  ZIP (if applicable)
Phone:        
E-mail:      

 

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 application by RCCM, you will be sent an invitation letter which will allow you to apply to the US Embassy in your country for a visitor's visa. The invitation letter will state that RCCM will be responsible for your food and accommodations from Saturday, April 25, 2009 until Thursday, April 30, 2009 at 10:00am.
Are you staying in the US after April 30, 2009, or are you arriving in the US before April 25, 2009?     
YES     NO

 

If yes, you must provide a detailed itinerary 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 World Ministry Conference 2009?    
YES     NO

The applicable confirmation fee is as follows:
For non-RCCM credential holders, $100 ($175 per married couple) by close of registration, January 31, 2009.
The confirmation fee is waived for all RCCM credential holders.

RCCM accepts all major credits card, or you may send a check or Money Order to:
World Ministry Conference 2009
3177 Lyell Rd. Rochester, New York, 14606. USA.
If you wish to use a Credit Card, you may do so on the next page after you have completed this form and clicked "Submit".

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

Please enter any additional comments below:

 

 

 

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