Name ______________________________________

  Org _______________________________________

  Address ____________________________________

  __________________________________________

  City/State/Zip ______________________________

  Phone/Fax _________________________________

  Email  _____________________________________ 

 Payment method: _____ check  # ________________

___ credit card  ____ MC ____ Visa   _____________

#__________________________________________
                                                        exp. date

___________________________________________
                                signature

   Before July 31, 2001         After August 1, 2001

___ 325 AGNT Members     ___ 375 AGNT Members 
___ 350 Non-members         ___ 395 Non-members 

Special  $175 Ministers Rate 

GROUPS OF FIVE OR MORE

___ 300 per person any date

GROUPS OF TEN OR MORE

PLUS

* 1 complimentary registration 
for eleventh registrant

(For group discounts: Correct no. of paid registrations 
must be submitted together)