2026 Womens Missionary and Educational Auxiliary Registration

If you prefer, you may download and print this form instead of filling it out online: Downloadable PDF Form

"*" indicates required fields

Company

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Your Name*

First Last

Your Email Address*

Your Phone Number*

Your Address*

Street Address Address Line 2 City State ZIP Code

Registration Type*

($25) Individual Registration

($50) Church Missionaries Registration

($100) Association Registration

($75) Individual + Church Missionaries Registration

($125) Individual + Association Registration

($150) Church Missionaries + Association Registration

($175) All Registrations

Individual Registration

Church Affiliation*

Church Address*

Street Address Address Line 2 City State ZIP Code

Pastor*

Association*

Church Name*

Missionary President*

Missionary President's Address

Street Address Address Line 2 City State ZIP Code

Pastor's Name*

Association Name*

Association Name*

Association President*

Association President's Address

Street Address Address Line 2 City State ZIP Code

Total

Payment Method

Credit Card*

Card Details

Cardholder Name

Please remit payments to:

The Virginia Baptist State Convention, Inc.
50 Moral Drive
Axton, Virginia 24054