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Conference Registration Form

Quantity	Description	Amount	Total
	Early Bird (before December 15, 2000)	$45.00
	Pre-Conference (December 15 to February 1)	$55.00
	After February 1,2001 & Day Of Conference	$65.00
	Student - College/Seminary (student ID required)*	$30.00
	EMNR Early Bird (before December 15, 2000)	$35.00
	EMNR Pre-Conference (December 15 to February 1)	$45.00
	After February 1,2001 & Day Of Conference	$50.00
	Banquet Reservations. (Required for those who are not paid registrants of the Conference) **	No charge for paid registrants**
TOTAL AMOUNT ENCLOSED

* Students enrolled at New Orleans Baptist Theological Seminary are admitted to the conference at no charge, however you must

show a valid NOBTS student ID when registering.

** Those that were not charged a conference fee and wish to attend the banquet must register for the banquet and purchase a banquet

ticket for $18.00.

Name: _________________________________________________________________

Organization (if applicable): ________________________________________________

Address: _______________________________________________________________

City: __________________________________ State: ___________ Zip: ___________

Day phone (____) _____ - _________ Evening phone (____) _____ - _________

Email: _______________________

____ Enclosed is my check for $__________

____ Please bill to my (circle the appropriate) MasterCard or Visa.

Card Number: _________________________ Expiration Date ____/____

Signature of cardholder: __________________________________

____ I cannot attend the Conference but would like information on ordering cassette tapes. 

Make Checks Payable in US funds to: EMNR Mail form(s) and payment to:

EMNR l 402 Office Park Drive, Suite G-20

Birmingham, AL 35223

For additional information, call (205) 871-2858

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