Online Registration Request Form

Thank you for filling out the registration request form. Make sure to answer each question in its entirety, especially questions that are marked with an (*) asterisk. These are required fields and you will not be able to submit this form unless these fields are filled in.

*Today's Date:
*First Name
*Last Name
*Are you affiliated with a Conference Committee, Board or Agency?
What Conference Committee, Board or Agency are you affiliated with?

Sorry but we are currently not able to take your request at this time. Online Registrations are currently available only to Conference Committees, Boards or Agencies. 

*Title of your Event:

As you would like it to appear on registration.

*Event Description:

Your description will appear at the opening of your form. Please enter text as you would like to have shown on the registration. Your text will be copied and pasted as entered.

*Event Date(s):

If multiple days, please list time span.

*Location of Event:
*Is this event open to all or by invitation only?
*Event Start Time:
*Event End Time:
*What date would you like your registration to go live?
*What date would you like your registration to close?

Note: Registration will close automatically on the day you indicate.

*Are you offering early registration?
What is the LAST day for early registration?
*Are you offering late registration?
What is the FIRST day of late registration?
*Does your event require a fee to be collected?
What is the standard fee amount?

(NOTE: PayPal charges a service fee of 1.9% plus $.30 for each transaction. If desired, please adjust your fee accordingly.)

What is the fee amount for late registration?
What is the fee amount for early registration?
*Do you require a deposit to be made?
What is the minimum deposit required?
*Do you want to use PayPal to collect registration fees?

(NOTE: PayPal charges a service fee of 1.9% plus $.30 for each transaction. If desired, please adjust your fee accordingly.)

*Do you have a fund account open with the Conference Office?
*Enter the Fund Account:
*Please specify how you would like payment to be received.

Note: Enter the exact text that you would like to have shown on the registration regarding how payment should be made. Your text will be copied and pasted directly as entered.

*Do you want registrants to register individually or in a group?

(select one)

*Do you want to allow registrants to edit their registrations after registering?

(Registrants  will not be able to edit their registration after registration closes.)

*Do you want to allow a list of registrants to be viewed publicly by all who register?
*What is the name and email address of the event coordinator?

(if different than contact)

*Do you want to receive email notification when someone registers for your event?
Enter the email address where notifications should be sent.
*What is your organizational contact information?

This information (contact person, name  of organization, address, telephone number, email address) will be added to the confirmation email for registrants to use if they have questions, etc. (see example below). 


"Name of Event"

Contact Information

CA-NV Annual Conference,  P.O. Box 980250, West Sacramento, CA 95798. 
Telephone number: (916) 374-1500 Email: XXXXXXXXX
Questions? Email: _____________________ 

*How would you like your 'confirmation message' to appear for registrants?


"Thank you for registering to attend the (name of event). Please review your answers and print a copy for your records. If you did not pay on line, mail your completed registration form and payment to the attention of (name of person) at CA-NV Annual Conference, P.O. Box 980250, West Sacramento, CA 95798 (or other address). Make the check payable to CA-NV Annual Conference and add "name of event" on the memo line. Please contact (name of contact person) at (phone #) or (email of person) with any questions (if different than contact person above). "

The standard registration form includes:

a. Contact Information: Name, address, email, telephone number 
b. Church or other affiliation 
c. Choice of dates and times of class/training/event to select. 
d. Payment information 
e. Event details 

If you want registrants to provide any additional information, please include those questions (or information) here.

*Our registration page is linked to our conference calendar of events. Would you like for your event to show on the conference events calendar?

If you select YES, your event will be publicized on the events calendar and also in the Instant Connection. 

Attach your event flyer, agenda or event documents.

Please include any attachments that pertain to your event. This may include photos of speakers, biographies, location pictures, etc. 

Attach file pdf, doc(x), xls(x), jpg/gif/png, ppt - up to 25 MB

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