All-Day Workshop Registration Form

The Samaritan Ministry, Inc. (a 501 (c) (3) Nonprofit Organization)

ALL DAY WORKSHOP REGISTRATION FORM

To register for the all-day workshop, print the registration form below, complete it, and then either Mail the completed form to:

The Samaritan Ministry, Inc.
14811 St. Mary's Ln, #138, Houston, TX 77079
or
Fax it to: 281-589-0520

Phone for information: 281/589-8936

On day of the workshop only, cell phone #713/857-7531

ALL-DAY WORKSHOP REGISTRATION FORM

Workshop Date:

Contact Name:

Address:

City: State: Zip:

Phone:

Church:

Number Attending:

Please provide list of Additional Attendees Names.

Charge Cards accepted
#: Exp.

Signature:

This form may be duplicated for additional registrations.

All-Day Workshop Information Link

Calendar of Events link

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