Please complete the following for your Digital Disciple Summit registration and to receive information for FETC registration, Hotel information, and Summit details. 

Thank you!

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* 1. What is your first name?

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* 2. What is your last name?

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* 3. What is your phone number?

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* 4. What is your mailing address?

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* 5. What is the best email to reach you? 

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* 6. Name of your diocese: 

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* 7. Name of your Parish or Organization.

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* 8. Your ministry title:

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* 9. Please describe your current ministry?

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* 10. Areas of the Summit that interest me (High Interest = 5 and Low Interest = 1). Please indicate your interest for all categories. 

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* 11.
In order to attend the Summit, I . . .

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* 12. Regarding DD Summit Sponsorships, I suggest that you contact: 

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* 13. One sentence description about your named sponsor.

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* 14. I agree that you can use my name when you contact this sponsor.

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* 15. I prefer to contact this sponsor myself. Please send me any information I may need to share with this contact.

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* 16. I understand that I am responsible for registering for FETC, arranging for my hotel where the DDN Summit group will gather, and providing my transportation to Orlando.  At the end of the Conference, depending on our Sponsor Drive, reimbursements will require the designated receipts with the required Summit Reimbursement form.  I understand that I may only be partially reimbursed.

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* 17. Do you have any other comments, questions, or concerns?

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