CONGREGATIONAL FORM

Both this completed form and all completed individual applications are to be submitted by church/congregation in one package.

 

Sponsoring Congregation: _________________________________________________

 

Contact Name: __________________________________________________________

 

Address: _______________________________________________________________

 

City: ____________________________ State/Province: ______ Zip: ______________

 

Email: _________________________________________________________________

 

Phone: _________________________________________________________________

 

Applicant one, name: _____________________________________________________

 

Applicant two, name: _____________________________________________________

 

Applicant three, name: ___________________________________________________

 

Applicant four, name: ___________________________________________________

 

Applicant five, name: ___________________________________________________

 

Total number of attendees:                           ________________

 

1 registrant         $450    (Note: These fees are non-refundable)

2 registrants         $500

3 – 5 registrants         $600

(Note: These fees are non-refundable) 

Total Congregation Fees                               $________________

 

Individual Tuition
with $200 deposit postmarked before April 28, 2008 and
a balance of $465 = $665 per person
       OR
$695 per person                                             $________________

 

Total Fees for NELS                                     $________________

 

Please Note: Attendee application(s) must be submitted along with this form and all payments. 

A non-refundable deposit of $200 per individual is required by April 28 to receive the early registration discount.

 

Make checks payable to North East Leadership School. Send to:

℅ Ingrid Holcomb

14 Ethan Allen Drive

Acton, MA 01720

978-621-8468

Ingrid.holcomb2@verizon.net