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Heartland Men's Conference | Men and mission for the millennium | What's a man to do?

HMC Home 2000
HMC Home 98

First Annual Heartland Men's Conference
Registration Form

Men & Mission for the Millennium:
What's a Man to Do?

November 14, 15, 1998
Pre-Conference Event: November 13

Days Inn Conference Center
I-70 and Stadium Blvd
Columbia, MO

(check those that apply)

Conference Fee (Nov. 14-15)


Pre-Conference Fee (Nov. 13)


Early Conference Fee (postmarked by Oct. 16)


Early Conference Fee for 2 (postmarked by Oct. 16)


Group Rate (6 or more registrants) (per person fee)
.....Must be sent together and postmarked by Oct. 16, 1998


Senior Rate (60 and over) ........Age: ______


Full-time Student
.....School: _____________________________


Saturday Only


Sunday Only


Certificate of Attendance


Total Enclosed

$ ________

Payment method: Check or Money Order payable to:

The Group Works - Patrick Kane, DCSW

To register, please return this form with proper fees to:

Heartland Men's Conference
c/o Patrick Kane
2100 E. Broadway, Suite 213
Columbia, MO 65201

Name: __________________________________________

Address: ________________________________________

Address: ________________________________________

City: _____________________ State: ___ Zip: __________

Phone: (______)________-_________________

Everyone who registers a week or more before the conference will receive a confirmation by mail. Attendance will be limited to 250 men and women.

For more information about this and other details, call Patrick Kane at The Group Works 573/449-0120 or e-mail: hrtlndmens@aol.com

Jeff Belden, webmaster
Date Last Modified: 2/20/2000

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