Be1Make1 Women's Conference Registration Only

Contact Information

Name*

First Last

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email*

Enter Email Confirm Email

Phone*

Emergency Contact Name, Relationship & Phone Number*

Example: John Doe, Spouse, (555) 555-5555

Conference Information

How did you find out about this event?

Please check all boxes that apply to you:

I am currently in a discipleship relationship as a Paul (mentor)
I am currently in a discipleship relationship as a Timothy (mentee)
I am currently part of a discipleship group.
I have heard about one-on-one discipleship, but I am not currently in a discipleship relationship and am excited to learn more.
I am unfamiliar with one-on-one discipleship, but I am excited to learn about it.

If you have any dietary restrictions, please list them below:

Additional requests/comments:

Agenda Information

We value your opinion! We would like for you to please help set the agenda for the day. Please answer the questions below, and once we review the input, we will set the agenda and email it back to you.

Please let us know where you consider yourself on your Christian walk: new believer, mature believer, or disciple maker? Please briefly explain why you chose that option.*

What personal challenges would you like to have discussed that might affect you or someone you know in your/their Christian walk?

Are you clear on your purpose in life (as a woman & as a Christian)? If not, please do your best to explain.

What is keeping you from making disciples? Check all that apply.

A lack of understanding of what it means to make a disciple.
Personal ongoing life-dominating sin.
I don’t feel qualified.
I don’t feel worthy.
I don’t have enough Bible knowledge.
If I could only.../Other (Please explain below)

If you selected "If only I could..."/Other above, please explain here:

If I were running this conference, I would make sure to cover the following topics:

Additional thoughts, ideas, questions, or concerns:

Donation Information

I would like to help sponsor another woman financially to attend. (Please enter an amount in the box below.)

($55 would be a full sponsorship)

I would like to give an additional financial donation and understand this will go directly to support the efforts of Be1Make1 events (including today’s).

Total

$0.00

Credit Card

American Express

Discover

MasterCard

Visa

Card Number Expiration Date Security Code Cardholder Name

Additional Comments

Total

$0.00

Email

This field is for validation purposes and should be left unchanged.

Be1 Make1 Women's Conference (10/19/2024) Registration Only

Contact Information

Conference Information

Agenda Information

Donation Information