9Marks: Survey - Weekender Registration

Weekender Registration

Did you read the entire Weekender description page, and everything it said about costs, housing, travel, refunds, as well as why, where, and what will happen? (If not, go back to the last page.)

Are you able to commit to the entire Weekender?

Then this application form is required for you to register for an upcoming Weekender conference. Please provide the following information. You will receive an online confirmation at the end of the registration process, and an email confirmation should follow shortly afterwards.

* indicates required fields

Contact Information

The following information will be used with purchases, donations, conference registrations, and communications regarding 9Marks events and resources. 9Marks is unable to ship material (including materials for the Weeknder) to a P.O. Box. Please do not use this as your address.

If you have previously registered, please login here to prepopulate your information.

Name:

First Required	Middle Required	Last Required

Email: Required

Street 1: Required

Street 2:

City/State/ZIP:

City Required	State Required	ZIP Required

Country: Required

Yes, I would like to receive e-mail from 9Marks

Yes, I would like to receive postal mail from 9Marks

Remember me. What's this?

Please enter a user name and password for logging in when you return. You can use this password to update your information or receive personalized content.

*	User Name: Required	5 to 60 characters
*	Password: Required	5 to 20 characters
*	Repeat Password: Required

Question - Not Required - Date of Birth:

Month

Day

Year

Question - Not Required - Preferred Phone Number (Home or Work):

Question - Not Required - Cell Phone:

*5.

Question - Required - I am a... (select your primary role)

Question - Not Required - If other, please specify:

Question - Not Required - If you are attending or have attended a college or university please enter the name of your college or university:

(Maximum response 255 chars, approx. 5 rows of text)

*8.

Question - Required - Have you attended a 9Marks Weekender in the past?

Question - Not Required - If you are attending Seminary or have attended Seminary please choose the name of your Seminary below.

10.

Question - Not Required - If other, please specify:

11.

Question - Not Required - Which degree are you seeking at seminary:

*12.

Question - Required - How did you hear about 9Marks?

13.

Question - Not Required - Are you interested in becoming a CHBC pastoral intern?

14.

Question - Not Required - Are you interested in learning more about running an internship program at your church?

Church Information

*15.

Question - Required - My church's name is:

*16.

Question - Required - Church Street 1

17.

Question - Not Required - Church Street 2

*18.

Question - Required - Church City

*19.

Question - Required - Church State:

20.

Question - Not Required - Church Zip

21.

Question - Not Required - Church Country

*22.

Question - Required - My church's denomination is:

23.

Question - Not Required - Church website:

Weekender Information

24.

Question - Not Required - Select Weekender Date:

*25.

Question - Required - How did your hear about the Weekender (if referred by someone, please enter his/her name)?

(Maximum response 255 chars, approx. 5 rows of text)

*26.

Question - Required - Please provide a personal profile, including Christian background, education, ministry experience, calling, etc. (Please limit your response to 200 words)

*27.

Question - Required - What are your goals and expectations for the Weekender? That is, what do you hope to get out of this conference? (Please limit your response to 200 words)

Food and Housing

28.

Question - Not Required - Do you have any dietary restrictions that you would like our food servers to know about?

(Maximum response 255 chars, approx. 5 rows of text)

29.

Question - Not Required - For Students Only: Do you need housing provided during the Weekender?