First Name: Last Name:

Address:

Street:

City:

State:

Zip Code:

Email:

Contact Phone: Cell:

Registration:

Single Registration Registration for 2 Registration for 3 Registration for 4 Registration for 5 Group of 5 or more Lunch Ticket Single Reg. w/1 Lunch Single Reg. w/2 Lunch Group Reg. w/Lunch

If registration is for a group, please list all names in the comments section below. Please leave any comments or special notes in the comments section below.

Comments:

Is this your first time to register for a WATWI Prophetic Gathering: Yes No, Previous Attendee

How did you hear about WATWI Prophetic Gathering:

Submit Registration Payment: Online through Paypal By Mail By Phone Door

Send Registration Confirmation by Mail: Yes No Send by Email

Send Conference Info. by Email: Yes No Send by Mail