Foundations for BeFriender Ministry – Virtual Workshop: October 4, 11, 18, 25, 2022 Workshop runs from 8:30 am – 5:00 pm Central Time Step 1 of 2 50% Church/Organization Name* Church/Organization Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Do you have a different mailing address?* Yes, I would like to provide a different mailing address No, I would prefer to use the address listed above Mailing Address 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 Your BeFriender Ministry Program* New Existing Restarting How many people are you registering?*(ie: 2, include yourself) How many are retaking BeFriender Ministry Leadership training?012345Please contact the BeFriender Office by email or at to 866-468-8708 register teams larger than 5. Prefix for Your Name TagRev.PastorYour Name* First Last Your Cell Phone*Your Work PhoneHome PhoneYour Email*Your Foundations for BeFriender Minsitry preparation email will be sent 7-10 days prior to the workshop. Your current role* Pastor BeFriender Volunteer Staff Other If you selected Staff or Other as your role, please describe Prefix for Team Member 2's Name TagRev.PastorTeam Member 2 Name* First Last Team Member 2 Cell PhoneTeam Member 2 Work/Home PhoneTeam Member 2 Email*Your Foundations for BeFriender Minsitry email will be sent 7-10 days prior to the workshop. Is your preferred mailing address the church address listed above or a home address?* Yes, I would like to use the church/organization address No, I would like to provide a home address Team Member 2's Home Address Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Current role of Team Member 2* Pastor BeFriender Volunteer Staff Other If you selected Staff or Other, please explain your role Prefix for Team Member 3's Name TagRev.PastorTeam Member 3 Name* First Last Team Member 3 Cell PhoneTeam Member 3 Work/Home PhoneTeam Member 3 Email*Your Foundations for BeFriender Ministry email will be send 7-10 days prior to the workshop. Is your preferred mailing address the church address listed above or a home address?* Yes, I would like to use the church/organization address No, I would like to provide a home address Team Member 3's Home Address Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Current role of Team Member 3* Pastor BeFriender Volunteer Staff Other If you selected Staff or Other, please describe your role Prefix for Team Member 4's Name TagRev.PastorTeam Member 4 Name* First Last Team Member 4 Cell PhoneTeam Member 4 Work/Home PhoneTeam Member 4 Email*Your Foundations for BeFriender Ministry email will be send 7-10 days prior to the workshop. Is your preferred mailing address the church address listed above or a home address?* Yes, I would like to use the church/organization address No, I will provide a home address Team Member 4's Home Address Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Current role of Team Member 4* Pastor BeFriender Volunteer Staff Other If you selected Staff or Other, please describe your role Prefix for Team Member 5's Name TagRev.PastorTeam Member 5 Name* First Last Team Member 5 Cell PhoneTeam Member 5 Work/Home PhoneTeam Member 5 Email*Your Foundations for BeFriender Ministry email will be send 7-10 days prior to the workshop. Is your preferred mailing address the church address listed above or a home address?* Yes, I would like to use the church address No, I will provide a home address Team Member 5's Home Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Current role of Team Member 5* Pastor BeFriender Volunteer Staff Other If you listed Staff or Other, please explain Date MM slash DD slash YYYY Early Registration Fee Price: $799.00 Quantity: Registration Fee Price: $849.00 Quantity: Workshop DiscountDiscount for people who have previously attended a BeFriender Foundations Workshop $0.00 Workshop DiscountDiscount for people who have previously attended a BeFriender Foundations Workshop $0.00 Workshop DiscountDiscount for people who have previously attended a BeFriender Foundations Workshop $0.00 Workshop DiscountDiscount for people who have previously attended a BeFriender Foundations Workshop $0.00 Workshop DiscountDiscount for people who have previously attended a BeFriender Foundations Workshop $0.00 I will be paying with: My personal credit card Church/organization card If you had been given a special registration code, enter it here and click apply Total $0.00 Billing Zip Code* ZIP / Postal Code Email for ReceiptIf you need a confirmation of payment email sent to another person, enter their email here. 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