Registration Form

"Come and See"  Event

October 1 & 2, 2009

Des Moines, IA

Name
Title
Address
Town    State 
Zip
Phone 
Email 
Institution/Organization represented
 I want to be considered for a scholarship.
 My $125 registration fee is enclosed.
I'm interested but these dates are not good for me.  Please keep me informed of similar opportunities.
Comments
 

* A $25 non-refundable deposit us required before registration form is processed.

Complete this form and click on submit to send to the director.

NOTE: Please send $125 registration fee or $25 deposit to:

Prison Congregations of America

PO Box 1132  

Mitchell, SD 57301     

Home  |  Mission  |  Model  |  Success  |  Contact  | Resources  |  Director  |  Board

Prison Congregations of America
P.O. Box 1132
Mitchell, SD 57301

www.prisoncongregations.org
Phone: 605-990-8330
Toll free: 800-417-6692
Fax: 605-990-4102
Email:mary@prisoncongregations.org

 

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