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. – PRESIDENTREV. 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. – PRESIDENTREV. 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 JacksonRegistrar – Phyllis TaylorFinancial Secretary – Saude Jordan

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 OFCHURCH: ______REGION______

ADDRESS OF CHURCH: ______

CITY/STATE/ZIP: ______

PASTOR OFCHURCH: ______

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 #: ______