Registration Form

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Print this page and mail with payment to:

Western Colorado Koinonia
c/o FPC 3940 - 27 ½ Road
Grand Junction, CO 81506

First:
Last:
Street:
City:	State:                       Zip:
Phone:
Email:
Sponsor:
Church:
Questions or Komments:

Cost is $75 per person (food and room). Total amount enclosed: _________________

I am interested in a scholarship to cover a portion of the cost. (Mail in form, and you will be contacted with details.) Scholarships are limited.

I need childcare, and live in the Grand Junction area.

Please make checks payable to First Presbyterian Church (WCK in memo line).