NELS ATTENDEE APPLICATION

To be filled out by each attendee and submitted by church/congregation.

Name: _______________________________________________________

Address: _______________________________________________________

City: ____________________________ State/Province: ______ Zip:

Email: ______________________________________________________

Day Phone: ______________________________________________________

Evening Phone: ______________________________________________________

Gender (for assignment purposes)

ڤ Female  ڤMale  ڤTransgender

Emergency Contact:

_________________________________________________

Emergency Contact Phone:

_________________________________________________

Enrollment requires the sponsorship of your church/congregation. Please submit this application to your Minister, President or Board Chair. That person must also write a letter of reference for you. Please also include a brief letter describing two reasons you would like to attend NELS and how you see yourself participating within your congregation or district in the future.

Sponsoring Congregation:

_________________________________________________

Contact Name:

______________________________________________________

Address:

______________________________________________________

City: ____________________State/Province: ______ Zip: _______

Email: ________________________________________

Phone: ________________________________________

ڤ letter of reference from minister or board included

ڤ personal statement included

Individual Tuition

Early Registration received by April 1 = $625

or

$695 per person

Please Note: This form along with payment must be submitted with church/congregational application.