Pittsburgh Glory Invasion Registration Form

November 11 & 12, 2011

Contact Information

Name

First Name*

Last Name*

Address

Street 1*

Street 2

City*

State*

Zip*

Phone Number

Required* --

Email Address

Registration

I'd like to register for...
Required*

	$30 for single attendance
	$45 for married couple
	Children 12 and under are free

Send Payment to:

Payment can by made by check to Latter Glory Ministries. Please send check via postal mail to: Latter Glory Ministries 10137 Clair Avenue Pittsburgh, PA 15235

Amount Enclosed

Required*