Address   
City             State    Zip   

Phone with Area Code (best number to be reached)    
E-Mail (required) 
Please retype E-mail

Congregation/Organization Name and Town

Participate in worship music (check if interested)

Vocal Instrumental (type )

Conference Fees

Registration is not finalized until payment is received. If registering online, please send check ASAP. Refunds are not available after September 15. Limited rooms with private bathrooms are available at Bishop Lane. Those willing to share a room will pay a reduced fee.

Registration for residents (program, meals, and housing)

$175 per person (through September 8)

$200 per person (after September 8)

Registration for commuters (program & meals)

$135 per person (through September 8)

$160 per person (after September 8)

Single-Day Registration (program & meals)

$100 per person (through September 8)

$125 per person (after September 8)

1/2 price discount for retired professonal leaders and seminarians

Deduct $10 for 2 in a room

Deduct $20 for 3 in a room

$ Total Registration Fee Enclosed

All meals are included, but, as good stewards, please note any meals that you plan to miss:
Monday noon, Monday evening, Tuesday morning, Tuesday noon
Tuesday evening, Wednesday morning, Wednesday noon

Send check, made payable to Northern Illinois Synod to:

Nancy Corey, Registrar, Augustana College - Lutheran House, Rock Island IL 61201-2296

For special registration arrangements, please contact Nancy Corey at 309-794-4004

Your registration is not complete until your check is received in the Rock Island Synod Office.