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ICMS Print-and-MailRegistration Form

 (Please print form and mail to address below)          Date ________________ 
______________________________________________________________________________

LAST NAME

FIRST NAME

MIDDLE INITIAL

______________________________________________________________________________

CHURCH

TITLE

______________________________________________________________________________

MAILING ADDRESS

______________________________________________________________________________

CITY

STATE

ZIP

______________________________________________________________________________

TELEPHONE

DENOMINATION

 
ERROR MSGSEMINAR AND COURSE REGISTRATION
 

COURSE TITLE	COURSE LEADER	TUITION
____________________________________	__________________________	$______
____________________________________	__________________________	$______
____________________________________	__________________________	$______
____________________________________	__________________________	$______
	TOTAL REGISTRATION	$______

ERROR MSGREGISTRATION FOR ICMS CERTIFICATE (ANNUAL FEE $ 75.00)    $______

_____PREACHING AND WORSHIP
_____CONGREGATIONAL LIFE AND RENEWAL
_____BIBLICAL STUDIES

 

TOTAL ENCLOSED

$______

 

cheap hotels in VeniceCHECKS PAYABLE TO ICMS -- MAIL TO P.O. BOX 1177, CLAREMONT CA 91711-1177

Questions? Call 909/621-0982 OR Fax 909/626-4100 or UseE-Mail Query Form Please send me more information on the following:
ERROR MSG___  Overnight Accommodations in Claremont
___  ICMS Certificate Brochure
___  Other  ______________________ 

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