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Discipleship to Missional Community East Coast Closer Look Registration

Welcome to PLI! We're looking forward to connecting with you at our upcoming Closer Look event, October 3-5. Please fill out a form for each person attending.

Contact Information

Name

*

First Name

Last Name

Home Address

*

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Cell Phone Number

*

Email Address

*

Verify Email

*

Congregation or Ministry Name

Please enter the full name including city and state in parentheses as shown in this example: Saint John Lutheran Church (Wheaton, IL)

Congregation or Ministry Address

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

How did you learn about the Closer Look Event?

email

social media

word of mouth

phone call

website

Custom text

What is your number one reason for attending this Closer Look event?

Amount

*

$50 - per person (includes teaching, coaching and some meals at this Closer Look event)