MINISTRY INISTRY MENTORS®

Print Form
MINISTRY
MENTORS
®
Thursday, October 6, 2016
1:30–4:30 p.m.
Winnetka Covenant Church
1200 Hibbard Road, Wilmette, IL 60093
Cost: $55 per person
Guest Speaker: Dr. Eboo Patel
Panel Members:
Imam Hazim Fazlic, Rabbi Wendi Geffen, Rev. Peter Hawkinson; moderator, Rev. Dr. Hal Edwards
Please TYPE or PRINT your name as you would like it to appear on your name tag:
Name
___________________________________________________________
Title
___________________________________________________________
E-Mail Address
___________________________________________________________
Church/Synagogue/Mosque
___________________________________________________________
Address, City, State
_____________
___________________________________________________________
______________________________________________
Phone
___________________________________________________________
Yes, please prepare a Continuing Education certificate.
Please print this form and mail with a check made payable to Ministry Mentors to:
Interfaith Leadership Event
Ministry Mentors
P. O. Box 2697
Glenview, IL 60025-2697
We will confirm your reservation via e-mail. Please be sure to PRINT your e-mail address.
www.ministrymentors.org