SUNSHINE DISTRICT
DISTRICT CONFERENCE REGISTRATION FORM

* Required Field

First Name: Last Name:
Address (Street, PO Box, etc.):
Address (City, State, Zip):
Church Affiliation:
Phone Numbers (home): (other):
*E-Mail: (If you don't have e-mail, print this form, complete it, and mail with your check.)

Please send $10 for registration and lunch to

Sunshine District Office
310 West 11th Street
Pueblo, CO 81001