2019 Assembly Registration We have modified the online registration system this year to streamline and simplify things. Registration includes access to the event and two meals (Friday Evening Banquet and Saturday Lunch). It does not include hotel accommodations. If you would prefer to register by mail, download the pdf registration form and return it to the Synod office by April 15, 2019. To register as a Vendor or Displayer, please visit the Vendor and Displayer Registration page. If you have questions or problems registering online, please contact Jason O'Neill at firstname.lastname@example.org or Christopher Harris at email@example.com. Who is completing this registration form?Name*Hi there! What is your name? First Last What is your preferred Email address, Loading...?* Add Attendee InformationAttendeesClick the 'Add Attendee' button to add the information for each person you would like to register for assembly. Name Will this attendee be a Voting Member or Visitor? Total   Edit Delete There are no Attendees. Add Attendee check balanceAssembly Registration Total Price: $0.00 PaymentSelect Payment Method*Credit/Debit CardCheck (Mail to Synod Office)Credit Card American ExpressDiscoverMasterCardVisa Card Number Month010203040506070809101112 Year20192020202120222023202420252026202720282029203020312032203320342035203620372038 Expiration Date Security Code Cardholder Name Your registration is not complete until we receive your check at the Synod office. Please mail your check today to the address below. All payments need to arrive on or before April 15, 2019. Please note the name(s) of the attendee(s) in the check memo. NT-NL Synod, ELCA 680 Copper Canyon Rd Argyle TX 76226 Save and Continue Later Name*Type the attendee's name exactly as it should be printed on their name tag. Only include a title if you would like it printed on your name tag. Please DO NOT use all caps. Ms.Mr.Dr.Pr.The Rev.The Rev. Dr.DeaconBp. Title First Last Date Registration TypeWill this attendee be a Voting Member or Visitor?*Voting MemberVisitorVoting Member Type*Voting Member - LayVoting Member - Rostered Minister of Word & SacramentVoting Member - Rostered Minister of Word & ServiceVoting Member - Lay SAWL (serving a congregation as pastor/leader on contract)Voting Member - Ordained SAWL (serving a congregation as pastor/leader on contract)Voting Member - Retired Rostered Minister of Word & SacramentVoting Member - Retired Rostered Minister of Word & ServiceVisitor Type*Visitor (guest, agency rep, etc.)Visitor - Spouse of Rostered LeaderVisitor - Seminary InternVisitor - Synod Guest/Staff/Planning Team Member/VolunteerFree Registration Price: $0.00 Early Registration FeeVoting Member Early Registration Price: $150.00 Retired Roster Voting Member Early Registration Price: $100.00 Visitor Early Registration Price: $25.00 Registration FeeVoting Registration Price: $165.00 Retired Roster Voting Member Registration Price: $110.00 Visitor Registration Price: $35.00 Optional FeesOrder a hard copy of the Assembly Reference Materials for this attendee for $25?Assembly Reference Materials was previously called the Book of Reports.YesNoAssembly Reference Materials (hard copy) Price: $25.00 Do you have a code for this attendee?YesNoSubtotal $0.00 Enter Discount CodeClick 'Apply' after you have entered your code so that your discount will be applied. Total $0.00 Attendee InformationPreferred Email* Phone*Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Congregation/CityAbiding Grace (Southlake, TX)Advent (Arlington, TX)Adviento (Arlington, TX)Ascension (Garland, TX)Beautiful Savior (Amarillo, TX)Bethany (Dallas, TX)Bethel (Avoca, TX)Calvary (Richland Hills, TX)Calvary (San Angelo, TX)Central (Dallas, TX)Christ (Dallas, TX)Christ the King (Haltom City, TX)Christ the Servant (Allen, TX)Christ the Servant (Denton, TX)Christ's (Odessa, TX)Common Grace (Stephenville, TX)Community of Hope (Fort Worth, TX)Covenant (Temple, TX)Damascus Road (Jacksboro, TX)Emanuel (Dallas, TX)Emmanuel (Granbury, TX)Faith (Flower Mound, TX)Faith (Fort Worth, TX)Faith (Sagerton, TX)Faith (Spearman, TX)Faith (Wichita Falls, TX)Finnish (Coppel, TX)First (Longview, TX)First (Temple, TX)First (Waco, TX)First Sagrada Familia (Garland, TX)First Salem (Roscoe, TX)First United (Dallas, TX)Four Mile (Mabank, TX)Gloria Dei (Garland, TX)Gloria Dei (Lubbock, TX)Good Shepherd (Irving, TX)Good Shepherd (Marshall, TX)Good Shepherd (The Colony, TX)Grace (Abilene, TX)Grace (Carrollton, TX)Grace (Fort Worth, TX)Grace (Slaton, TX)Holy Trinity (Irving, TX)Holy Trinity (Shreveport, LA)Hope (Comanche, TX)Hope (Midland, TX)Hope (Springtown, TX)Immanuel (Killeen, TX)Immanuel (Slaton, TX)Joy (Rockwall, TX)King of Glory (Dallas, TX)King of Glory (Fort Worth, TX)Kyrie Pub Church (Fort Worth, TX)Lord of Life (Glenn Heights, TX)Messiah (Weatherford, TX)Midland (Midland, TX)Mount Olive (Dallas, TX)New Hope (Keller, TX)New Life in Christ (Duncanville, TX)Oslo (Gruver, TX)Our Redeemer (Grand Prairie, TX)Our Savior (Mesquite, TX)Our Savior's (Clifton, TX)Our Saviour's (Durant, OK)Peace (Vernon, TX)Preston Meadow (Plano, TX)Redeemer (Greenville, TX)Rejoice (Coppell, TX)Rejoice (Frisco, TX)Resurrection (Plano, TX)Salem (Rosebud, TX)San Gabriel (Alvarado, TX)San Miguel (Fort Worth, TX)Santa Maria (in Exile) (Irving, TX)Shepherd King (Lubbock, TX)Shepherd of Life (Arlington, TX)St Andrew (Hurst, TX)St John (Bartlett, TX)St John (Dallas, TX)St John (Gatesville, TX)St John (Wilson, TX)St Luke's (Richardson, TX)St Martin (Littlefield, TX)St Matthew (Waco, TX)St Matthew's (Fort Worth, TX)St Olaf (Cranfills Gap, TX)St Paul (Crawford, TX)St Paul (Shive, TX)St Paul (Levelland, TX)St Peter (Malone, TX)St Stephen (Shreveport, LA)Trinity (Clifton, TX)Trinity (Clovis, NM)Trinity (Fort Worth, TX)Trinity (Pottsville, TX)Trinity (Lockney, TX)Trinity (Sherman, TX)Trinity (Wichita Falls, TX)Trinity Ev (Miles, TX)Umoja International (Dallas, TX)Umoja International (Ft. Worth, TX)Walnut Hill (Dallas, TX)Zion (McGregor, TX)OrganizationIf no congregation aboveAge Range18 & Under19-3637-5556-6970+¿Necesita traducción en Español durante la Asamblea?(Do you need translation in Spanish during the Assembly?)Sí / YesNo / NoDoes this attendee have any special needs?(e.g. wheelchair access, vegetarian, food allergies, ...)YesNoPlease list the attendee's special needs.(e.g. wheelchair access, vegetarian, food allergies, ...)Emergency Contact InformationEmergency Contact Name*Please list an emergency contact NOT ATTENDING assembly. First Last Emergency Contact Phone*Relation to Emergency Contact*Official Opportunity for Voting MemebersAre you willing to serve on a Standing Committee?YesNoPlease check your top two choices.*Members of these committees are selected based on location and gender in an attempt to give a fair representation across the NT-NL Synod. Elections Reference & Counsel Credentials Minutes Volunteer OpportunitiesI am a VISITOR and would be interested in serving as a Facilitator (aka—Table Runner).YesNoI am knowledgeable about electronic devices and willing to help at the IT Table.YesNoI am a Rostered Minister / SAWL / Staff person / Mission Council member and plan to have my photo taken for the Synod Website photo gallery.YesNoI am a Lay Person and would like to receive electronic publications from the Bishop’s Office.YesNoUnique ID This iframe contains the logic required to handle Ajax powered Gravity Forms.