PENNSYLVANIA BAPTIST STATE CONVENTION
PENNSYLVANIA BAPTIST STATE CONVENTION
122ND ANNUAL SESSION
59TH ANNUAL SESSION of the PBSCCE
ANNUAL SESSION of the Youth & Young Adult
REV. BENJAMIN T. HAILEY, SR. – PRESIDENT REV. CLIFFORD CARTER – VICE PRESIDENT AT-LARGE
SISTER BERTHA HODGE, PA CONGRESS, PRESIDENT
DR. BRUCE ALICK, PA CONGRESS, DIRECTOR DR. ELAYNE ARRINGTON, PA CONGRESS DEAN
MIN. NATALIE WINFREY, PA YYAM, DIRECTOR BRO. BERNARD LAMBERT, YYAM PRESIDENT
THEME: “Authenticating Our Purpose, and Realizing Our Promise”
SCRIPTURE: Isaiah 61/Luke 4:17-21
PA STATE CONGRESS THEME: “Words to Live By”
SCRIPTURE: LUKE 2:49b –
“I must be about my Father’s business.” (KJV)
MONDAY JULY 29 THROUGH FRIDAY AUGUST 2, 2013
VALLEY FORGE CONVENTION CENTER
RADISSON HOTEL
1160 FIRST AVENUE
KING OF PRUSSIA, PA 19406
Instructions for Completing the Registration Form
GENERAL INFORMATION: All delegates (including pastors, officers, instructors, children, youth, etc.) must register and be counted. Registration Fee is $100.00 per delegate.
This Registration Fee entitles each delegate to a PBSC Kit (Bag), PBSC Souvenir
Journal, PBSC T-shirt, PBSCCE Class, and a Ticket to the President’s Award
Banquet (Adults) or Youth Awards Banquet and Dorney Park (Youth/Young Adults).
This Registration Fee does not include HOTEL ACCOMMODATIONS, TRANS-
PORTATION, MEALS ( except for the President’s Awards and Youth Banquet) or the
SPECIAL MINISTRY CELEBRATION GATHERINGS (See list below).
TICKETS for the following SPECIAL MINISTRY CELEBRATIONS
are available through the respective ministry leaders on-site:
*DR. BENJAMIN F. MOORE FELLOWSHIP LUNCHEON–THURS.,AUG. 1ST – 12 P.M.
*LAYMEN’S LUNCHEON (OFF SITE) TUES., JUL. 30TH – 11 A.M.
*MINISTERS’ WIVES AND WIDOWS LUNCHEON – TUES., JULY 30TH – 12 P.M.
*USHERS’ AND NURSES’ BREAKFAST – WED., JULY 31ST – 8:30 A.M.
*WOMEN’S MINISTRY DINNER – TUES., JULY 30TH – 4:30 P.M.
HOTEL ACCOMMODATIONS: Delegates are responsible for making their
own Hotel reservations. The room rate is $103.00 per room per night
for singles, doubles, triples or quadruples. Please make your reservations
as soon as possible. Call: RADISSON HOTEL - 610-337-2000
or for info call: JESSIE BROWN – 717-944-3953
MEAL TICKETS: Sister Jessie Brown is in the process of negotiating a MEAL
TICKET PLAN with the hotel. She will share this information as soon as
it is available.
MAKE ALL CHECKS PAYABLE TO: Pennsylvania Baptist State Convention
MAIL TO: SISTER SAUDE JORDAN, PBSC Financial Secretary
937 E. FULTON STREET
LANCASTER, PA 17602-2449
ONLINE REGISTRATION: Register online at Visa and MasterCard charge cards are accepted
MEDICAL FORMS: Please complete a “medical Form” for each delegate. Send it
with your other registration materials.
PRE-REGISTRATION DEADLINE: July 8, 2013 – Please register on or
before Monday, July 8th, so that the PBSC/PBSCCE can prepare adequately.
ON-SITE REGISTRATION: The Registration Area will be opened Monday
through Thursday, July 29th – August 1st, 8 a.m. to 5 p.m. Please “Check-in”
at the Registration Area as soon as you arrive on-site and pick up your
registration materials.
DELEGATE BAGS will contain a Souvenir Journal and T-Shirt. The Bags, Class
Cards, President’s Award Banquet Tickets and Youth Banquet/Dorney Park Tickets will be given to the designated CHURCH/ASSOCIATION representative
responsible for picking up and distributing his/her church’s/association’s
registration packets.
TEXTBOOKS: A limited number of textbooks will be available to order with your
registration or they can be purchased on-site.
SECTION 1 – CHURCH/ASSOCIATION REGISTRATION – Please type or print legibly.
Press hard enough to go through all 3 copies of the form. Respond to all items.
The DELEGATES listed in this section as “Designated Voters” are those
members of your church’s/association’s delegation who will represent your
church/association and participate in the election. The number of “Designated Voters” may not exceed the number of delegates allowed according to your
church’s/association’s membership as recorded on your registration form. (Remember only churches/associations that have registered for the 121st and
122nd Annual Sessions of the PBSC are eligible to vote.)
SECTION 2 – CHURCH DELEGATE REGISTRATION FORM - Please type or print legibly.
Press hard enough to go through all 3 copies of the form. Respond to all items.
Remember, all delegates must register. Please include the delegate’s First and
Last Names, Age (C= CHILD, Y=YOUTH, YA= YOUNG ADULT, A=ADULT).
(Ages 0-11) (Ages 12-17) (Ages 18-35) (Ages 35+)
Gender (M or F), Ministry (PBSC, PBSCCE, or YYAM), T-Shirt Size (XS, S, M,
L, XL, XXL, etc.), Dorney Park (C/Y/YA) or President Awards Banquet (All Adults), Youth Banquet (YYAM delegates) and Class Choices (1st and 2nd).
CLASS/LIST OF COURSES: The List of Courses is available online
or you can request a copy from your Area Vice President, PBSCCE Dean’s
Office or the Registrar.
PENNSYLVANIA BAPTIST STATE CONVENTION
REV. BENJAMIN T. HAILEY, SR. – PRESIDENT REV. CLIFFORD CARTER – VICE PRESIDENT AT-LARGE
SISTER BERTHA HODGE, PA CONGRESS, PRESIDENT
MINISTER NATALIE WINFREY, PA YYAM, DIRECTOR BROTHER BERNARD LAMBERT, YYAM PRESIDENT
CHURCH REGISTRATION FORM
Please complete Sections 1 and 2 of this Registration Form (See page 1 for Instructions) and mail along with your check
or money order made payable to : PENNSYLVANIA BAPTIST CONVENTION
937 E. FULTON STREET
LANCASTER, PA 17602-2449
SECTION 1: CHURCH REGISTRATION or ASSOCIATION REGISTRATION
(Please print or type.)
SESSION: Annual____ Mid Year____ Brd. Meeting _____ Other_____ DATE: __________
REGION: ___________________________ ASSOCIATION: __________________
COMMUNITY: RURAL ________ URBAN _______ SUBURBAN ________
CHURCH: ___________________________ PASTOR: ____________________
CHURCH ADDRESS: ________________________________________________
CITY/STATE/ZIP: ___________________________________________________
PHONE #’S: CHURCH’S _________________ PASTOR’S _________________
CHURCH’S MEMBERSHIP: __________ ANNUAL FEE: _______________
Annual Registration Fees are based on Church Membership. Association Fees are based on the number of churches represented. Please use the chart below to determine your Annual Registration Fee for your Church or Association.
FEE: CHURCHES BY MEMBERSHIP ASSOCIATION BY CHURCHES REPRESENTED
1-25 |Members |$100.00 |2 Delegates | |1-25 |Churches |$500.00 |2 Delegates | |26-50 |Members |$200.00 |3 Delegates | |26+ |Churches |$1,000.00 |5 Delegates | |51-100 |Members |$250.00 |4 Delegates | | | | | | |101-150 |Members |$300.00 |5 Delegates | | | | | | |151-200 |Members |$350.00 |6 Delegates | | | | | | |201-300 |Members |$400.00 |7 Delegates | | | | | | |301-500 |Members |$600.00 |8Delegates | | | | | | |501-999 |Members |$800.00 |9 Delegates | | | | | | |1,000+ |Members |$1,000.00 |10 Delegates | | | | | | |
DELEGATES (Designated Voters)
1. _____________________________ 6. ____________________________
2. ______________________________ 7. ____________________________
3. ______________________________ 8. ____________________________
4. ______________________________ 9. ____________________________
5. ______________________________ 10. ___________________________
Church Registration Received: $___________ Reclaim: $ ______________
Church Registration Balance Due: $___________ Individual: $ 100.00________
Received by: ______________________ Check #:____________Receipt #: _______
Note: First payment in Mid-Year Session/Balance due in Annual Session- White Copy –Registrar Yellow Copy – Financial Secretary Pink Copy – Church
Treasurer – Rev. James Jackson Registrar – Phyllis Taylor Financial Secretary – Saude Jordan
jj@ flyphyltt@ saudjordan@
PA Congress Registrar, Joan Tracey YYAM Registrar, Juanita Harris
SECTION 2: CHURCH DELEGATE REGISTRATION FORM
(Please print or type. PRESS HARD ENOUGH TO GO THROUGH ALL 3 COPIES.)
Please fill in all information requested on this Registration Form. Make checks payable to: Pennsylvania Baptist State Convention (PBSC)
Mail to: Mrs. Saude Jordan, Financial Secretary
937 E. FULTON STREET
LANCASTER, PA 17602-2449
NAME OF CHURCH: ________________________________REGION________
ADDRESS OF CHURCH: _____________________________________________
CITY/STATE/ZIP: ___________________________________________________
PASTOR OF CHURCH: _____________________________________________
NAME/ADDRESS/PHONE NUMBER (OF PERSON SUBMITTING REGISTRATION)
_________________________________________________________________________________
_________________________________________________________________________________
REGISTRATION FEE: $100.00 PER DELEGATE. Fee includes Bag, T-Shirt, Class and Banquet
Ticket (Adults) or Youth Banquet and Dorney Park Tickets (Youth/Young Adult).
DELEGATE’S NAME/ADDRESS |AGE |M/F |MINISTRY |SIZE |DORNEY PARK/
PRES. BANQUET |CLASS
1ST CHOICE |CLASS
2ND CHOICE | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | SUMMARY TOTALS:
# ADULTS: ________ FEE TOTAL (# DELEGATES X $100.00): ___________
# YOUNG ADULTS: ___________ CHURCH FEE: ___________
# YOUTH: __________ AMOUNT DUE: __________
# CHILDREN: __________ AMOUNT PAID: ____________
TOTAL DELEGATES: __________ DATE: ________________________________
Received by: _________________________ Check #:____________Receipt #: _______
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