2005 Outreach Leadership Institute

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OLI Registration

Download the registration form or fill out this form online, print it, and mail it with your registration fee to:

LEA Outreach Leadership Institutue
7400 Augusta St.
River Forest, IL 60305

You can also fax the registration form to (708) 209-3458.

Registration deadline is July 1, 2005.

Registration is limited to the first 200 people—register early!

Each participant must complete a registration form.

Once registered, all participants will receive a separate mailing of Institute materials, including a form for indicating their top three choices of modules.

Your name
Last name
First name
Name on tag
Middle Initial
Spouse's name (if registering)
Last name
First name
Name on tag
Middle Initial
Home address
City		State
Zip
Home phone	() -
E-mail address
Congregation
Church address
City		State
Zip
Church phone	() -
Church fax	() -
This is my	1st 2nd 3rd 4th 5th Outreach leadership Insitute
I am:
Administrator DCE DCO	DPM Volunteer lay worker Teacher	Pastor Harvester for Christ Deaconess
Other
I would like to receive continuing education credits. (Additional fee and requirements are involved. E-mail or call Carol Klempka, 651-641-8724.
Roommate choice A roommate will be assigned if one is not chosen.

Fees (Fees incude program, meals and activities.)
$160	After May 1 -- $175
$150	LEA members, After May 1 -- $165
$240	Nonmember of LEA with 1-year LEA membership, After May 1 -- $265
$125	for registration without room on campus. After May 1 -- $140

Registration refund policy: Through June 1, a full refund minus $50. After June 1 and before July 1, a 50% refund. No refunds after July 1.