Bishop Rueben Job Center for Leadership Development
(a ministry for the North Central Jurisdiction of the United Methodist Church and beyond)
Dakota Wesleyan University
1200 West University Avenue
Mitchell, SD  57301
605-995-2166
605-996-1766 fax

 

You can use this form to register for any of the seminars.  Print out the form and mail or fax it to us, e-mail us the form's information by standard e-mail, or call and register by phone.  If you have any questions, please contact us.

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Registration Form

Seminar Name

Seminar Date(s)

Seminar Location

Name

Church Name

Annual Conference

Position (check one)       (    ) Pastor       (    ) Staff    (    ) Layperson    (    ) Other

Mailing Address

City

State

Zip

Phone (O)

Phone (H)

E-Mail Address

Payment Method (check one)     (    ) Check   (    ) Credit Card   (    ) Other (specify)

For Credit Card Users

Card Type (check one)        (    ) MasterCard            (    ) Visa                   (    ) Discover

Cardholder Name

Card #

Expiration Date

 

        

NOTE: Credit Cards are processed through the Dakota Wesleyan University Business Office.

Please let us know if you need any special accommodations (such as accessibility or dietary restrictions).

 Cancellation Policy

Cancellation notices received before the seminar start date will be refunded at 50 percent of the paid registration fee.  Cancellations received on or after the seminar start date will result in refund forfeiture.

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