Registration Form

Kogudus Renewal Ministry

Retreat Registration

Date of Retreat ____________________    Location _______________________

Name _______________________________________

Address ____________________________________



Phone(s)  ____________________________________________________

Email ________________________________________________________

Church Home __________________________________________________

Registration Fee Enclosed  $ __________________

Donations make it possible to provide scholarships.
If you need a scholarship, please indicate here:__________

Illinois Retreats Contact: John Cross; 2650 700th Ave. Emden, IL 62635,217-737-7270;

Montana Retreats Contact:  Pastor Greg Karlsgodt, 2622 Grassland Dr, Missoula, MT 59808; 406-544-1922;

North Dakota Retreats Contact: Paul Hendrickson, 2759 67th Ave. NW, Parshall, ND; 701-743-4554;

           Come, Holy Spirit!                         Revive Your Church!                       Begin With Me!

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