E4 2021 Registration

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Association of College Ministries
July 12-15, 2021 Hotel Louisville

Complete one form for each conference attendee by June 25.
(After June 25, we will ask for a late fee)

Questions? Contact Mark Pike at 765.289.7133 office; 765.748.5798 mobile; mark.pike@comcast.net

Email *

Name *

Spouse Name (If Attending)

Ministry Name *

University / College *

Phone # *

List Names and Ages of any children attending with you

Room Selection - Price includes room selection, Tuesday and Wednesday evening meals, breakfast and the conference program. Dinner on Monday and lunch is on your own. *

2 adults in shared room $170 per adult

4 adults in shared room $120 per adult

1 adult in single room $225 per adult

Commuter $50 for program and meals for the conference

I would like to share a room with...

Registration *

Room Selection (above)

$25 discount for first year serving in campus ministry

Add late fee of $25, if registration sent June 26, 2021 or after

Dues (if not yet paid) $200 Full/main ministry or $100 Full/satellite ministry or $50 for basic listing

Required

Total cost sent to ACM (from above) *

Payment *

Paying by Check - make checks payable to ACM, send to ACM c/o Mark Pike, 1411 W. Riverside Avenue, Muncie IN 47303

Credit card payments - www.aofcm.org and choose resources: online payment

Contact Mark -765.748.5798 mobile / mark.pike@comcast.net

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