2022 Kirtland Priesthood Assembly Registration Form

Please fill out as completely as possible. There is a $15.00 non-refundable fee to cover costs. Please mail fee or bring to the retreat. Make checks payable to “Conference of Restoration Elders” with a memo “Kirtland Fee.” The Coordinating Council is responsible for approving registrations if there is a question concerning eligibility. Fees may be mailed to the CRE PO Box 4085, Independence, MO 64051. All travel, lodging, and dining arrangements are to be made by each individual. The following motels are within 5 miles of the Kirtland Temple: Best Western, Days Inn, Motel 6, Super 8, and Red Roof Inn. For additional information contact the CRE office by phone, 816.836.3421, or email the CRE at eldersconference7@gmail.com.

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* 1. Please enter your name and contact information.

Name:

Address:

City/Town, State, & Zip:

Email Address:

Phone #:

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* 2. Indicate current priesthood office you hold.

Deacon

Teacher

Priest

Elder

Seventy

High Priest

Bishop

Patriarch

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* 3. Please provide the ordination date of your current priesthood office, and the name and priesthood office of the men who ordained you. Please list spokesman first. (This information is not required if you have been previously approved)

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* 4. Please provide the name and location of the Restoration Branch/Group you attend; or if you are not active in a Restoration Branch, please explain your situation.