| REGISTRATION FORM |
| Name: |
| Address: |
| E-mail: |
| Church Name: |
| Phone: |
| I am a: |
| Registration Fee $55 Includes Friday, June 21st Banquet Make checks payable to: Cry of His Coming Evangelistic Association 6864 Silver Star Rd. Orlando, FL 32818 |
| Yes |
| Do you need hotel accomodations? |
| No |
| City: |
| State: |
| Zip: |