Registration

ONLINE REGISTRATION FORM

BLACK METHODISTS FOR CHURCH RENEWAL, INC.

46th Annual Meeting - March 13-15,2013

Westin Chicago Northwest Hotel

400 Park Blvd, Itasca, IL 60143

Please complete and mail this form to: BMCR, P.O. Box 801, Nashville, TN 37203 or email: bmcr@umpublishing.org.

LATE REGISTRATION DEADLINE HAS BEEN EXTENDED UNTIL FEBRUARY 28, 2013

CLICK HERE FOR A PRINTABLE VERSION OF THIS FORM>>

FOR ADVERTISING AND EXHIBITOR & VENDOR TABLES. Click here to register.

If you do not plan to attend the meeting, but would like to be current on your membership dues click here>>

Registration includes: Registration fee, National Membership dues and Banquet ticket!

Bishop Dr. Minister Mr. Mrs. Ms. Pastor Rev. Rev. Dr.

Full Name Company

Email (required)

Address

City State Zip

Phone

Jurisdiction Annual Conference

This is my 1st 2nd National BMCR Annual Meeting

Registration Fees:

Early Registration [through Nov. 30, 2012] Registration includes Registration fee, national Membership fee and Banquet ticket
Adult $300.00	Sr. Retired $265.00	Associate $210.00	Student $135.00
EARLY REGISTRATION FOR HARRY HOSIER, LIFE OR CENTURY MEMBERS Adult $200.00, Sr. Retired $165.00
General Registration [through Jan. 15, 2013] Registration includes Registration fee, National Membership fee and Banquet ticket
Adult $325.00	Sr. Retired $290.00	Associate $235.00	Student $160.00
GENERAL REGISTRATION FOR HARRY HOSIER, LIFE OR CENTURY MEMBERS Adult $225.00, Sr. Retired $190.00
Late Registration [through Feb.28, 2013] Registration includes Registration fee, National Membership fee and Banquet ticket
Adult $375.00	Sr. Retired $340.00	Associate $285.00	Student $200.00
LATE REGISTRATION FOR HARRY HOSIER, LIFE OR CENTURY MEMBERS Adult $275.00, Sr. Retired $240.00

On-Site Registration [AFTER Feb. 28, 2013] Registration includes Registration fee, National Membership fee and Banquet ticket
Adult $400.00	Sr. Retired $380.00	Associate $325.00	Student $225.00
LATE REGISTRATION FOR HARRY HOSIER, LIFE OR CENTURY MEMBERS Adult $300.00, Sr. Retired $280.00

Registration Type:

Adult Standard (includes Registration fee, National Membership fee and Banquet ticket)

Adult Hosier, Life, Century (MUST be paid in full or current with payments)

Sr. Retired Standard (includes Registration fee, National Membership fee and Banquet ticket)

Sr. Retired Hosier, Life, Century (MUST be paid in full or current with payments)

Student Standard (includes Registration fee, National Membership fee and Banquet ticket)

Associate Standard (includes Registration fee, National Membership fee and Banquet ticket)

DO NOT ADD MEMBERSHIP FEES TO THESE AMOUNTS. MEMBERSHIP FEES ARE INCLUDED.

Extra Tickets:

One banquet ticket is included in the registration fee. For additional tickets, please select below. PLEASE PLAN TO CONCLUDE ALL ONSITE TICKET PURCHASES BY WEDNESDAY, MARCH 13, 2013

Black College Fund Luncheon $45.00
Gammon Luncheon $45.00
Wesley Seminary Breakfast $35.00
Banquet $65.00 (1 banquet ticket is included with registration)
NEW: No Garrett Evangelical Theological Seminary meal will be held at the hotel.

CANCELLATION POLICY: All cancellation notices and requests for refunds must be in writing from the registered person. If you need to cancel, your existing fees may be transferred to those of another attendee. We will accept cancellations, with documentation, due to medical issues or death of an immediate family member. For cancelling 30 days before meeting date, $50 will be deducted from the total cost. For cancelling less than 30 days before meeting date, $100 will be deducted from the total cost. NO REFUNDS WILL BE HONORED THE WEEK OF, DURING, OR AFTER THE MEETING. Cancellations after the meeting will not be honored.

I would like to:

Sing with the BMCR Choir

Perfom with the musicians (must bring your instrument)

I am volunteering to usher on:

Wednesday night Thursday morning Thursday Night

I require special needs:

I am hearing impaired

I am visually impaired

I require language translation - specify language (i.e. "French"):

I require special meals - specify (i.e. "vegetarian"):

I have other special needs - specify

Memberships:
Names of Hosier, Life and Century members must be on file in the National BMCR office. Please contact the BMCR office if you need to confirm Century, Life and Hosier Membership registrations.

Membership Options:

Century (Voting) $750 (Pay in 5 consecutive yearly increments of $150)
Life (Voting) $1,500 (Pay in 5 consecutive yearly increments of $300)
Hosier (Voting) $2,500 (Pay in 5 consecutive yearly increments of $500)

I am a Hosier Life Century member. Names of Hosier, Life and Century members must be on file in the National BMCR office. Please contact the BMCR office if you need to confirm Century, Life and Hosier Membership registrations.

I wish to pay on my Century, Life or Hosier membership:

Yes

EARLY REGISTRATION DEADLINE: NOVEMBER 30, 2012.

PLEASE DO NOT MAIL ANY REGISTRATIONS AFTER

FEBRUARY 15, 2013

.

ONLINE REGISTRATION CLOSES ON FEBRUARY 15, 2013.

AFTER THAT YOU WILL HAVE TO REGISTER ONSITE AT A HIGHER REGISTRATION RATE!

Payment Options:

Print this form BEFORE clicking "submit" in order to mail it in with your check payment.

Proceed with submission and pay online via electronic check or credit card.