Assemblies of God Bible Alliance

Registration Form
Ninth Annual Fire Bible Summit
November 29-30, 2010 Maui, Hawaii

YES!

 Please reserve my/our entry to the 2010 Fire Bible Summit in Maui.
      (Deadline for registration is June 1, 2010)

 We have already provided 800 Fire Bibles ($8,000) in 2010.

 We will give the 800 Fire Bibles ($8,000) by . 
     (Deadline is November 1, 2010. Registration is confirmed upon receipt of funds.)

Make checks payable to Assemblies of God Bible Alliance or Light for the Lost.
All gifts to the Bible Alliance receive LFTL credit. Please send payments to:
1445 N Boonville Ave 
Springfield, MO 65890-0206
Please note this information on checks to Bible Alliance:
4755633 (40)   2010 Fire Bible Summit     SC:PG

Title Rev.Rev. and Mrs.Mr.Mr. and Mrs.Dr.Dr. and Mrs.Ms.Mrs.Miss  Name

I represent (Name of Church, District, Business) 

I am the pastor   I attend the church   Other 

Church/Business Address

City  State  Zip

Phone  E-mail

Home Address

City  State  Zip

Phone  E-mail

Please mail correspondance to:  Church/Business   Home

My spouse is attending  

               is not attending

Other Guests (Please list all persons who will be staying in room.)

Room request   king bed    double bed   
Special Requests 

Reservation Dates: Arriving    Departing

Please enter me in (one event per person):

 Fire Bible Golf Classic
Name

            My partner will be

            Please assign me a partner.

 Fire Bible Fishing Tournament

Name 

          My partner will be

           Please assign me a partner

 Fire Bible Shopping Tournament

Name