Wisconsin Conference United Methodist Women
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Charter for Racial Justice Programs
2014 MISSION ACTION DAY REGISTRATION FORM
Online Registration Deadline is March 10, 2014 at 5:00 PM
Indicates required field
Please select phone type:
No phone available
Please Select A District
I don't belong to a district in Wisconsin
Please Select Gender
Please Choose Which Category Fits You Best:
UMW District Officer
UMW Conference Officer
Please Only Check Those That Apply:
Child Care Needed
If you put a check in one of the boxes above, please include number and ages of children and/or explain special needs/diet:
NOTE: If you are bringing children, please bring a sack lunch for each child or register them separately and pay $12.00 for each child.
Please select Form of Payment:
I will be sending my registration money to Shirley Carpenter.
I will be paying at the door on the day of event.
All fields with a red asterick (
) are required fields and must be filled in.
Registration $12.00 per person, includes lunch.
Please make checks payable to:
WI Conference UMW
2711 North Biron Drive
, Wisconsin Rapids, WI 53140
NOTE: If you register for this event, please be sure to pay your registration and show up to the event.
We need an accurate head count for lunch. Registrations are transferrable, not refundable.
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