Please print this page and mail to the address below

REGISTRATION FORM FOR ASSEMBLIES of GOD MARRIAGE ENCOUNTER

Last Name___________________ His First__________________ Her First_____________________

                                                                                                                          (Preferred to be called)

Address______________________________________________ City________________________ 

State_________________ Zip__________________ 

 EMAIL________________________________________  Phone  (        )______________________

Wedding Date____________  Weekend Location/Date_____________________________________

Your Church______________________________________________

M.E. was Recommended By_________________________________

Attach $75.00 Registration Fee  (Non-refundable)                                                    

Payable to A.G.M.E.  and mail to: