Keith Barr Ministries

Name *

First Name

Last Name

Phone *

(###)

###

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Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Date of Event *

MM

DD

YYYY

Can you cover the cost of transportation? *

Yes

No

If necessary, can you provide hotel accommodations?

Yes

No

Would our team be able to sale our Books/Merch? *

Yes

No

This is a virtual conference