Great Lakes Annual Conference Conference Registration Fee Waiver Request Name(Required) First Last Your Location(Required) City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State Email(Required) Local Church Name(Required) Are you a Youth Worker with 3+ youth attending annual conference from the same church?(Required) Yes No Are you a voting delegate to annual conference?(Required) Yes No Is your local church able to pay for a portion of your registration?(Required) Yes No How much could your local church cover?(Required)Please enter a number less than or equal to 50.Why is your local church unable to pay for a portion of your registration?(Required)Select One(Required) Laity Clergy Your Signature(Required)
