Register Return Home Step 1 of 5 20% * REGISTRATION IS NOT COMPLETE UNTIL PAYMENT IS RECEVIED.Prefix(Required)BishopDr.Mr.Ms.Name(Required) First Last Phone(Required)Email(Required) Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Episcopal District(Required)PiedmontEastern North CarolinaNorth EasternWestern West AfricaEastern West AfricaMid-AtlanticSouth AtlanticMid-WestSouthwestern DeltaWesternAlabama-FloridaCentral Southern AfricaAnnual Conference(Required)If unknown, please write "Unknown"District(Required)If unknown, please write "Unknown"Local Church(Required)Life Member(Required) Yes No First Time Attendee(Required) Yes No Age Group(Required) 18-40 41-60 Over 61 Emergency ContactName(Required) First Last Phone(Required)Relationship(Required) RegistrationRegistration includes Convention bag, Welcome Reception, Life Member Reception, Challenge Luncheon and Candidates Breakfast.For group table registrations, please email Cynthia White at clctreasurer11@aol.comThis field is hidden when viewing the formTimestampREGISTRATION MAIL-IN DEADLINE: July 11, 2025Please make all checks and money orders payable to: Connectional Lay Council P.O. Box 26770, Charlotte, NC 28221Late Registration (July 1, 2025)/On-site Registration Price: Early Registration by May 31, 2025 Price: Pre Registration by June 30, 2025 Price: Additional Ticket(s) for Victor J. Tulane BanquetPrice: $50.00 Yes No Special Physical or Dietary Needs(Required) Yes No Please explain your physical or dietary needs(Required)Additional Registrants Name Additional Registrant Subtotal Actions Edit Delete There are no Registrants. Add Registrant Maximum number of registrants reached. Additional Registrations Price: $0.00 Total Payment Method(Required)GivelifyCheck or Money OrderMail to CLC OfficeATTENTION:To complete your registration, payment must be received by the specified deadlines. If payment is received after the selected date, the appropriate amount for the later deadline will apply. For checks, the postmark date must be on or before the chosen deadline, and the payment must be received by the corresponding date. Payments received or postmarked on or before May 31, 2025 will register for $175.00.Payments received or postmarked on or before June 30, 2025 will register for $185.00. Payments received or postmarked on or after July 1, 2025, and those made onsite, will register for $200.00 Δ
