GENERAL CONFERENCE INFORMATION

The Conference begins Wednesday afternoon with lodging registration.
Please check in by 6:00 p.m. Dinner begins promptly at 6:30 p.m.
The Conference ends Friday at 1:30 p.m.
Conference Registration Fee is $25 per person, which covers lodging for two nights and all meals during the Conference.
Please dress comfortably, and be prepared for a moderate amount of walking, both indoors and outdoors.

October 21-23, 2009(deadline is October 9, 2009) March 17-19, 2010 (deadline is March 5, 2010)

PERSONAL INFORMATION

Mr. Mrs. Miss Ms.

Last name: First: Middle:

Single Married Engaged Date of Birth:

Spouse Attending? Yes No Name of Spouse:

Street address: Apt. or PO Box:

City: State: ZIP Code:

Email:

Primary phone number: Secondary phone number:

Restrictions: Dietary Mobility None

PROGRAM INFORMATION (Please indicate the program that most interests you.)

Master of Divinity (residential) Master of Divinity (distance) Master of Arts in Religion 3/3 (BA and MDiv)

BACKGROUND INFORMATION

College Attended: Major: Date of Graduation:

Denomination:

Current Occupation: Employer:

How did you hear about this conference? Pastor Alumni Internet Advertisement Other

PAYMENT INFORMATION

$25 per person

Check will be mailed. Checks are payable to UDTS. Mail to: Office of Seminary Admissions, 2000 University Avenue, Dubuque, IA 52001

Please charge my credit card, Card Number: Visa Card Master Card Discover

V-Code is: Expiration Date:

Card Holder's Name:

Check constitutes electronic signature