2018 Staff Conference Registration We are glad to see you're interested in joining with Lutheran Campus Ministry staff and guests for the 2018 ELCA Campus Ministry Staff Conference! In order to register for this event, please complete and submit the following registration form.Registrant Basic InformationRegistration IDName of Registrant* First Last Gender Pronounsshe/her/hershe/him/histhey/them/theirsEmail* Enter Email Confirm Email Cell Phone*Work Address* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code School/Area You Serve*Job Title*ELCA Region*Region 1Region 2Region 3Region 4Region 5Region 6Region 7Region 8Region 9Organization Name*Emergency ContactName* First Last Relationship*Phone*Registration & HousingRegister for…*New Staff Orientation & Conference ($165)Conference Only ($215)Room Preference*No housingStandard room (w/ roommate)Early ArrivalPlease note that an extra night of housing does incur an additional cost ($50 for double occupancy rooms and $100 for single occupancy rooms). I will be arriving early and need housing on Tuesday night. Roommate Preference*No roommate preferenceBringing spouse/partnerRequest roommateName of Requested Roommate* First Last Personal Needs & PreferencesFood AllergiesFood PreferencesDo you have any mobility issues we could help accommodate?Ministry InvolvementsPlease describe your connection to campus ministry.*Current PractitionerFormer PractitionerLSM StudentFriend of Campus MinistryAre you interested in helping with worship music?*YesNoWhich instrument(s)?Group QuestionnaireAre you…?OrdainedRostered LeaderLay LeaderFull time / Part timeFull time position in Campus MinistryFull time position in 2 or more campus ministries (split call)Full time position split into a part time campus ministry and part time congregational or other type of ministry.Part time position serving in a full time ministry (you are one of multiple staff, sharing the position)Part time position (you are the only minister/leader of the campus ministry)How many years of service do you have in campus ministry?*0-5 years6-10 years11-15 years16+ yearsAre you retiring this year?*YesNoWhen?Is your campus…Mostly residentialMostly commuterA fairly equal mix of residential and commuter studentsIs your campus in a setting that is…RuralUrbanWhere do programs/worship/fellowship take place?Your campus ministry has your own house or centerYou share a house/centerYou meet in a church but students are not really connected to congregational lifeYou meet in a church and students are very closely involved with congregational life.You don't have a place of your own but meet in public spaces.About how many students do you meet/see on a regular basis?1-1011-2425-5051-100100+Of the students that you see regularly,Most identify as LutheranMost identify as ChristianMost identify without a religionSome identify as Lutheran but there is also a strong presence of another denomination (methodist, episcopal, presbyterian)Grade the following items from 1 to 9 (1 is our campus ministry does this super super well! 9 is our campus ministry doesn’t really do this at all.)WorshipBible studyDinner and fellowshipPresence on campusRetreats/trips/spring breakPresence in the community outside of campusFundraising (for special projects or annual budget)Encouraging spiritual growth in participantsCommunity servicePaymentMember Discount Code Total $0.00 Payment Option*Register & Pay Online TodayRegister Only & Send Payment via Postal MailCredit Card* American ExpressDiscoverMasterCardVisa Card Number Month010203040506070809101112 Year20182019202020212022202320242025202620272028202920302031203220332034203520362037 Expiration Date Security Code Cardholder Name Please send your registration dues to: Ben Adams, LuMin Treasurer 1101 East 56th Street Chicago, IL 60637 Makes checks payable to LuMin and write Conference Registration on the memo line. PhoneThis field is for validation purposes and should be left unchanged. This iframe contains the logic required to handle Ajax powered Gravity Forms.