Please enable JavaScript in your browser to complete this form.Name of wife *FirstLastName of husband *FirstLastEmail *Phone *Address *Address Line 1CityStateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeWhere are you active in a Faith community? *How many years have you been together and married? *Do you have children? If so, how many? *How did you hear about this Conference? *What is your goal or expectation of this Conference? *Here are all the details: this Conference will be held at the Counseling Center, 2601 Freeland Ave., San Angelo, TX 76901, 2 blocks behind Lonestar Middle School, on the corner of Campus and Freeland (the frontage road), Friday night, November 3 from 6:00pm-8:30pm (dinner included) and Saturday, November 4 from 9:00am-3:00pm (coffee and lunch included). Anything else we should know about you?Registration price per couplePrice: $ 100.00Stripe Credit Card *CardName on CardSubmit