Name *

School, Church or Ministry *

Position *

Email Address *

Phone Number *

Organization/Individual Address *

Record Attendees

Ticket Type	Price	Quantity
KEM Prime Members (1st person from organization)	$179
KEM Prime Member Additional attendees from organization	$149
Non-KEM Prime Member (After May 10)(1st person from organization)	$249
Early Bird Non-KEM Prime Member (Feb - May 10) (1st person)	$199
Non-KEM Prime Member Additional Attendees	$179
Sub Total

Additional Attendee #1 - Name and Position

Additional Attendee #2 - Name and Position

Additional Attendee #3 - Name and Position

Additional Attendee #4 - Name and Position

Additional Attendee #5 - Name and Position

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