The Johnson Symposium on Faith & Society Registration *Field is required for processing Name* First Last Address* Street Address City State ZIP / Postal Code Email* Phone*Do you need accessible seating or amplification device? Yes You indicated "Yes" above. Please describe your accommodations for accessibility.*Cost is on a sliding scale. Participants are encouraged to donate $0-$30, based on what feels appropriate for your situation. Do you wish to submit payment?*I would like to submit payment at this time.I would like to receive a full scholarship for this event.Please enter dollar amount you are contributing. Total $0.00 Please enter your payment details below. All payments will appear as "HOLY TRINITY LUTH CH" on your bank statement. Payment made here is over a secured connection. Your data is encrypted and safeguarded.Credit Card Card Details Cardholder Name How did you learn about the Johnson Symposium?FacebookTwitterI received a notice in the mailI am a Holy Trinity memberFrom a friendI saw a flyer This iframe contains the logic required to handle Ajax powered Gravity Forms.
