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DISTRICT 23

SJG Group Registration Form

Church Name

Church Address

Phone Number

Name of person completing form

Pastor

Name1

Email1

Phone1

Fee1

Name2

Email2*

Phone2*

Fee2

Name3

Email3*

Phone3*

Fee3

Name4

Name5

Name6

Name7

Name8

Name9

Name10

Email4*

Phone4*

Fee4

Email5*

Phone5*

Fee5

Email6*

Phone6*

Fee6

Email7*

Phone7*

Fee7

Email8*

Phone8*

Fee8

Email9*

Phone9*

Fee9

Email10*

Phone10*

Fee10

Name11

Name12

Name13

Name14

Name15

Name16

Name17

Name18

Email11*

Phone11*

Fee11

Email12*

Phone12*

Fee12

Email13*

Phone13*

Fee13

Email14*

Phone14*

Fee14

Email15*

Email16*

Email17*

Phone15*

Fee15

Phone16*

Fee16

Phone17*

Fee17

Email18*

Phone18*

Fee18

Name19

Email19*

Phone19*

Fee19

Name20

Email20*

Phone20*

Fee20

Total Fees

Early Bird Registration Deadline: February 1, 2024 (postmarked)

Thanks for registering this year. See you there!

This form no longer accepts submissions.

ABOUT US

The West Virginia & East Tennessee Council (WVETNC) is the 23rd Episcopal District of the international Pentecostal Assemblies of the World (P.A.W.), a Christian organization that is the oldest Apostolic Pentecostal organization in existence. The WVETNC is one of 13 districts in the eastern United States that was uniquely founded through direct involvement and leadership of longtime P.A.W. Presiding Bishop Samuel J. Grimes.

ADDRESS

304.529.1290

P.O. Box 1679
Bluefield, WV 24701

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