DISTRICT - National Baptist Congress Online Registration 2013

Category District - $550.00 (up to 3 Delegates, $25 each add'l)

This form is only for registering Districts. Please return to the Convention website to select a different formif you are registering as an Individual, Church or State Convention.

Please have all of your delegate names and first and second choice class selections on hand. If changes or additions are needed after you submit this form for processing,contact the Congress Registration office (see below). Changes cannot be made online after you submit your form .

This form will accept up to 13 Delegates.

If you need to register more than 13 Delegates, as soon as possible, forward a copy of the registration confirmation email that you receive after submitting this form to the Congress Registration Office, along with the names and first and second classes choices for the additional delegates.

Congress Registration Office Communication

(Note that we will try to get back to you as soon as possible, but due to high work volumes you should allow up to 48 hours for a response.)

Preferred contact method is email: congressregistration@nationalbaptist.com

Mr. Maurice Lauher, Special Assistant, Registration
P.O. Box 769
Fort Mill, SC 29716
Phone/Fax: 803.396.0805 (call before sending a fax)

(For technical issues with the online registration system,
contact Dr. Denise Mayhan at webmaster@nationalbaptist.com)

Note: Turn off the autofill feature in your browser if it's on (If you don't, it will automatically populate ALL of the delegate fields with YOUR personal information).

* Means required field

Contact Name*

First Name Last Name

Phone Number*

- Area Code Phone Number

E-mail*

District Name*

Moderator Name*

Prefix First Name Last Name

District Address*

Address Line 1
Address Line 2
City	State / Province
Postal / Zip Code	Country

District Phone*

- Area Code Phone Number

District Email

District Website

My District's NBC, USA, Inc. Registration Status (select one)*

Registered with the NBC, USA, Inc. Not registered with the NBC, USA, Inc. Don’t know/Not Sure

I would like to see the Congress develop online and mobile learning programs and applications.

Yes No Not Sure

The subject areas and/or types of programs I would like to see the Congress focus on developing are:

The computer and mobile platforms I am interested in are (check all that apply):

Other Platform(s):

I would like to see more Congress information, networking and learning opportunities on (check all that apply):

Facebook Twitter Website Email Web-based Meetings/Webinars Self-paced, self-study programs Other (list below)

Other Method(s):

Name

Prefix First Name Last Name

Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Instructions

Fill in the delegate name (s) and then select first and second class choices by ENTERING THE CLASS NUMBER (not the name).

When you have finished entering your delegates and their class numbers, scroll to the bottom of the page to submit this form and enter your payment information.

Class Availability Look-Up Tables

Click on the links below to look up classes by name or by class number. These documents are updated continuously. Each document will open in a new window for your convenience. You can save time by copying and pasting the class information into the class choice boxes below, or you can also type the information into the box. The Closed Classes List link will open in a new window on the National Baptist website where you can view the current lising of classes that are full and have been closed.

Classes List by Name Classes List by Number Closed Classes List

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1. Delegate Name