IBC Ladies’ Seminar Registration

Please note, your registration will not be complete until your registration fee is received. You can send to:

Independent Bible Church
Ladies’ Seminar
69 Foote Avenue
Duryea, PA 18642

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Name *

First

Last

Address *

Address Cont.

City, State and Zip *

Phone Number *

Email *

Home Church *

Number Registration Name

Number of Attendees *

Additional Attendees Names and Addresses

Registration Confirmation *

• I understand the $15 registration fee is non-refundable and that my registration is not complete until this fee has been received.

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