Kempke Music Service

Attention:
Please fill out a form for EACH PAID registrant attending
(so we can have the correct information for their name tag)
and we will get back to you as soon as it is processed.
If you should have questions, please call us at 1-800-753-6753

* - required fields

* First Name :

*Last Name ::

Church Name ::

Kempke Acct# ::

* eMail address ::

*Address ::

City::

*St ::

Zip ::

Church Phone ::

Church Fax ::

Home Phone ::

Please indicate which staff member helped you the most
in making your decision to attend the conference.

*Please make your selections

Additional Lunch Tickets for Guests Thursday

$20

Additional Lunch Tickets for Guests Friday

$20

Description

Thru 6/01/08

After 6/01/08

Check Box

Adult Choral Program Registration

Continental Breakfast, Lunch and Breaks Included

$139

$159

Associate/Student/Spouse Registration
(No Packets Included)

Continental Breakfast, Lunch and Breaks Included

$79

$99

Please indicate which staff member helped you the most in making your decision to attend the conference.

Please indicate which staff member helped you the most
in making your decision to attend the conference.