Team Registration

Contact Information
Agency Contact Name*
First Last
Phone*
Email*
Enter Email Confirm Email
Organization Name
Are you associated with a denomination or church planting association? If yes please list the name.
Website
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Team Options
Couples Attending Quantity
Please indicated # of couples attending. Price is per couple.
Price: $1,495.00
Individuals Attending Quantity
Price is per individual.
Price: $1,195.00
Team Workshops
Onsite workshops. ** Travel expenses will be billed separately ** Only complete if you would like GLI to travel to you
- Medium Team (5-10people)
- Large Team (10+)
List the name, role and email for each person attending.*
Click the + symbol to add additional people to your list
Name Role/Position Email Years In Ministry Degree? If so please list
Coupon
Total
$0.00
Payment Options*
Payment By Check
Agencies who request to pay by check please note that the payment must be received in our offices 30 days prior to the assessment center. We will not issue any pre-assessments to attendees if payment hasn't been received in our offices. Please enter your name below stating you understand these conditions.
Credit Card*

American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name
Billing Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
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Comments
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Team Registration

Contact Information

Team Options

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Name	Role/Position	Email	Years In Ministry	Degree? If so please list