Ordination Module - The Missional Leader • Alliance NW

Module Attendee 0

Module Attendee Information

First Name *

Last Name *

Email Address *

Mobile Number

Church *

Role *

Are you a module speaker or staff? *

Yes

Is this your first time attending a module? *

Yes

Tip: First time attending a module? You are required to attend an Ordination

Please let us know which modules you have attended by filling out the month and year in the appropriate boxes below. Leave all unattended modules blank, including the one you are registering for. Please use the MM/YYYY date format.

Spirit Filled Leader Module Attended (MM/YYYY):

Missional Leader Module Attended (MM/YYYY):

Formed Leader Module Attended (MM/YYYY):

Pastoral Leader Module Attended (MM/YYYY):

Please select any dietary restrictions below that apply to you: *

None of the Following

Dairy Free

Vegetarian

Gluten Free

The ANW will cover lodging during the module (March 17 & 18). *

Yes, I will need lodging

No, I do not need lodging and will arrange on my own

Tip: You will have your own individual rooms and will not be sharing rooms.

Check in date

Check out date

Ground Transportation

Yes, I will need ground transportation

No, I do not need ground transportation

Flight Information (Inbound)

Tip: Date & Time of arrival (PDX)

Flight Information (Outbound)

Tip: Date & Time of departure (PDX)