Receive the Boost Registration Form

Name(s):

Status:

Address:

City:

State:

Zip:

Phone:

E-mail:

Will you want to be wedded at the conference?

Yes

Will you be reaffirming your marriage vows?

Yes

Fees

Date:

Signature

Make check or money order payable to Divine Visitation International Ministries
Mail to P. O. Box 831385
Stone Mountain GA
404-219-0286, 678-698-6550

DIVINE VISITATION INTERNATIONAL MINISTRIES
Break Loose!!!
Receive the Boost Relationship Conference

REGISTRATION FORM
Printable Form