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cmtc@cmtc.org
Conference Registration Form
Brett Webber
2021-12-21T11:34:04-05:00
Conference Attendee Information
$145 per person for 1-2 attendees $115 per person for 3 or more attendees
1st Attendee Information
Name
(Required)
First Name
Last Name
Title/Position in church/organization
(Required)
Cell Phone
(Required)
Email
(Required)
Online Registration Fee
(Required)
Price:
Online Registration Fee
(Required)
Price:
2nd Attendee Information (optional)
2nd Name
First
Last
title/position in church/organization
Online Registration Fee
(Required)
Price:
Online Registration Fee
(Required)
Price:
3rd Attendee Information (optional)
3rd Name
First
Last
title/position in church/organization
Online Registration Fee
(Required)
Price:
4th Attendee Information (optional)
4th Name
First
Last
title/position in church/organization
Online Registration Fee
(Required)
Price:
5th Attendee Information (optional)
5th Name
First
Last
title/position in church/organization
Online Registration Fee
(Required)
Price:
6th Attendee Information (optional)
6th Name
First
Last
title/position in church/organization
Online Registration Fee
(Required)
Price:
7th Attendee Information (optional)
7th Name
First
Last
title/position in church/organization
Online Registration Fee
(Required)
Price:
8th Attendee Information (optional)
8th Name
First
Last
title/position in church/organization
Online Registration Fee
(Required)
Price:
9th Attendee Information (optional)
9th Name
First
Last
title/position in church/organization
Online Registration Fee
(Required)
Price:
10th Attendee Information (optional)
10th Name
First
Last
title/position in church/organization
Online Registration Fee
(Required)
Price:
11th Attendee Information (optional)
11th Name
First
Last
title/position in church/organization
Online Registration Fee
(Required)
Price:
12th Attendee Information (optional)
12th Name
First
Last
title/position in church/organization
Online Registration Fee
(Required)
Price:
Conference WorkBook
Conference Workbook
Quantity
Price:
$55.00
Quantity
It is highly recommended that you purchase a workbook to gain the maximum benefit from the conference. By purchasing your workbook(s) now, you will be guaranteed to have one reserved for you at the conference. Select the number of workbooks you would like to purchase for $55 each. NOTE: workbooks purchased on location will be $65 each (if available).
Priority Code
Church or Organization Information
Name of your Church/Organization
(Required)
 
Church/Organization Address
(Required)
Street Address
Address Line 2
City
State
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
ZIP Code
How Did You Hear About Us?
(Required)
Please choose one...
Radio
Brochure/Postcard
Email
Web Engine
Social Media
Please select the source that best describes how you heard about CMTC and our conference/seminar.
Are You A Current Monthly Client of Chitwood & Chitwood?
(Required)
Please choose one...
Yes
No
Yes/No - (This information is for internal use only and not required to attend this seminar)
Do You Have Active Ministerial Credentials With ICCM
(Required)
Please choose one...
Yes
No
Yes/No - (This information is for internal use only and not required to attend this seminar)
Select Seminar Date/Location
(Required)
Please choose one...
Please Select Location
Baltimore, MD - 01.28.25
Philadelphia, PA - 01.29.25
Flushing, NY - 01.30.25
Tampa, FL - 02.04.25
Ft. Lauderdale, FL - 02.05.25
Florence, SC - 02.11.25
Charlotte, NC - 02.12.25
Atlanta, GA - 02.13.25
San Antonio, TX - 02.19.25
Houston, TX - 02.20.25
Jackson, MS - 02.25.25
Shreveport, LA - 02.26.25
Dallas, TX - 02.27.25
Pensacola, FL - 03.12.2025
Albany, GA - 03.13.2025
Please select the date and location of the conference/seminar you wish to attend from the dropdown list.
Doors open - 8:00 am Event - 8:50 am to 3:30 pm Event time zone
Refund Policy
Refunds will be made if written notice of cancellation is received five days prior to the conference. If you become unable to attend after full payment has been made and less than five days before the event, you may send a substitute. All refunds are subject to a 10 percent service fee.
Payment Information
Credit Card
(Required)
American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number
Expiration Date
Month
Month
01
02
03
04
05
06
07
08
09
10
11
12
Year
Year
2024
2025
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
2036
2037
2038
2039
2040
2041
2042
2043
Security Code
Cardholder Name
Billing Address
Is Billing Address Same As Contact Address?
Billing address is same as Contact address
Billing Address
(Required)
Street Address
Address Line 2
City
State
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
ZIP Code
Total
Captcha
Total
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