Arizona 5 Day Academy 2023 AZ 5 Day Academy 2023 AZ 5 Day Academy pre-registration form for October 23rd-28, 2023 Name* First Last Mailing Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Email* Gender Are you Clergy or Laity Clergy Laity What is your denomination? Pre-Registration Fee* Hold my spot with a $200 partial payment Save the date You can save the date and be added to the 2023 Academy mailing list, or make a $200 refundable deposit for a spot now. The $200 can be refunded up to August 1st 2023.Scholarship Form RequestDSC clergy may apply for scholarship assistance with the Conference Board of Ordained Ministry. Some scholarship funds are available for laypersons from the Desert Southwest Conference. For information, please contact Jerry Haas, retreat leader at firstname.lastname@example.org. Yes Special Diet RequestNoneVegetarianVeganGluten SensitivityOther - Fill in belowPlease let us know if you have any dietary issues.If other please name other diet request Total to Pay Now $0.00 Credit CardCard Details Cardholder Name CommentsThis field is for validation purposes and should be left unchanged.