Media Exemption SubmittedNoYesIMPORTANT INFORMATION BEFORE PROCEEDING! Church staff often handle the registrations for their members attending assembly. Please gather each person's INDIVIDUAL INFORMATION (home address, phone number and email address etc.) so that we can confirm this registration with them directly and communicate important information about assembly. There is also a place to include your email if you wish to receive a confirmation of the registration process for your members.We are unable to provide group registration due to the nature of information that must be collected for each voting member; however, we can send one invoice to pay for all registrations via Paypal. Please note the directions at the bottom of this form. Before you beginSynod Assembly 2021 will be an online event. Due to this format we have several important things for you to be aware of before you register yourself or others. 1. We must have personal contact information for each voting member. 2. We will not be able to accommodate "walk-in" registrations on the day of Synod Assembly. The deadline for voting member registration is noon on April 26, 2021. 3. Guests and visitors will not be able to join the Zoom meeting but may watch the assembly on our Facebook livestream. The link will be posted on the synod assembly event page the week before the assembly.Contact informationToday's Date Date Format: MM slash DD slash YYYY This registration is for:*someone elsemyselfAdditional confirmation emailEnter an email address to receive a confirmation for this registration. About the attendeeCheck all that apply. We seek this information to fulfill our commitment to be more diverse. (If neither apply, please skip this section.) I am a person of color English is not my first language GenderWhat are your pronouns?ex: she/her, he/him, they/them Learn more about personal pronouns here. A video with more detailed information is here.Rostered minister titleIf you are a rostered minister please note your title.Rev.Rev. Dr.DeaconName*We confirm voting credentials directly from this field. Please provide a proper name with appropriate capitalization. Do not enter titles here. A title field is provided above this field. First name only Last name Attendee's home address*Do not use the church address. We need the home address of the attendee. Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Attendee's phone*Attendee's email*Please provide your correct email address to receive important information from us about your registration. We do not share your email address outside of our office. Enter email Re-enter email (these fields must match) Choose your congregation and city*Please choose the name of your congregation and city from this dropdown menu. Take note that there are several congregations with the same name.My congregation is:OtherAbiding Savior Lutheran Church, MilwaukeeAdoration Lutheran Church, GreenfieldAdvent Lutheran Church, CedarburgAll Peoples Gathering Lutheran Church, MilwaukeeAll Saints Lutheran Church, Oak CreekAll Saints Lutheran Church, WalesAscension Lutheran Church, MilwaukeeAscension Lutheran Church, WaukeshaAtonement Lutheran Church, MuskegoBay Shore Lutheran Church, Whitefish BayBethania Lutheran Church, RacineBethel Lutheran Church, MuskegoBethlehem Evangelical Lutheran Church, MuskegoBreaking The Chains, MilwaukeeCapitol Drive Lutheran Church, MilwaukeeChrist Lutheran Church, JacksonChrist Lutheran Church, MequonChrist Lutheran Church, SalemChrist Our Savior Lutheran Church, SussexChrist The King Lutheran Church, DelafieldChrist The King Lutheran Church, Port WashingtonChrist The Servant Lutheran Church, WaukeshaChrist the Victor Lutheran Church, New BerlinCross Lutheran Church, BurlingtonCross Lutheran Church, IxoniaCross Lutheran Church, MilwaukeeDr. Martin Luther Lutheran Church, OconomowocEmaus ELCA, RacineFaith Lutheran Church, CedarburgFaith/Santa Fe Lutheran Church, MilwaukeeFirst Lutheran Church, West AllisFirst United Lutheran Church, SheboyganFox Point Lutheran Church, MilwaukeeGalilee Lutheran Church, PewaukeeGethsemane Lutheran Church, BrookfieldGloria Dei Lutheran Church, Menomonee FallsGood Shepherd Trinity Church, MilwaukeeGrace Evangelical Lutheran Church, ThiensvilleGrace Lutheran Church, GraftonGrace Lutheran Church, KenoshaHephatha Lutheran Church, MilwaukeeHoly Communion Lutheran Church, RacineHoly Cross Lutheran Church, Menomonee FallsHoly Trinity Lutheran Church, West AllisHouse Of Prayer Lutheran Church, FranklinImmanuel Lutheran Church, CedarburgIncarnation Lutheran Church, MilwaukeeJackson Park Lutheran Church, MilwaukeeJourney in Faith, RacineKing Of Glory Lutheran Church, GreenfieldKingo Lutheran Church, MilwaukeeLake Park Lutheran Church, MilwaukeeLakeside Lutheran Church, KenoshaLincoln Park Lutheran Church, GlendaleLiving Christ Lutheran Church, GermantownLiving Faith Lutheran Church, RacineLiving Hope Lutheran Church, SaukvilleLord Of Life Lutheran Church, KenoshaLuther Memorial Lutheran Church, West AllisLutheran Church of the Great Spirit, MilwaukeeLutheran Church Of The Redeemer, RacineLutheran Church Of The Resurrection, PewaukeeLutheran Church Of The Resurrection, RacineMartin Luther Lutheran Church, MilwaukeeMemorial Lutheran Church, MilwaukeeMessiah Lutheran Church, RacineMessiah Lutheran Church, Twin LakesMount Carmel Lutheran Church, MilwaukeeMount Hope Lutheran Church, West AllisMount Olive Evangelical Lutheran Church, MukwonagoMount Pleasant Lutheran Church, RacineMount Zion Lutheran Church, WauwatosaNativity Lutheran Church, WauwatosaNorth Cape Lutheran Church, FranksvilleNorway Evangelical Lutheran Church, Wind LakeOur Savior Lutheran Church, HartlandOur Savior Lutheran Church, OconomowocOur Savior Lutheran Church, West BendPeace Lutheran Church, BurlingtonPeace Lutheran Church, MilwaukeePrince of Peace Lutheran Church, MilwaukeeRedeemer Lutheran Church, HartfordRedeemer Lutheran Church, MilwaukeeRedemption Lutheran Church, WauwatosaReformation Lutheran Church, BrookfieldReformation Lutheran Church, MilwaukeeResurrection Lutheran Church, New BerlinSpirit Alive Lutheran Church, KenoshaSpirit Of Peace Lutheran Church, MilwaukeeSt Andrew Lutheran Church, SheboyganSt John Lutheran Church, GraftonSt John Lutheran Church, JacksonSt John Lutheran Church, KenoshaSt John Lutheran Church, OconomowocSt John's Evangelical Lutheran Church, West MilwaukeeSt John's Lutheran Church, BrookfieldSt Luke Lutheran Church, GreendaleSt Luke Lutheran Church, Sheboygan FallsSt Luke Lutheran Church, SlingerSt Luke's Lutheran Church, WaukeshaSt Mark Lutheran Church, CudahySt Mark Lutheran Church, WaukeshaSt Mary Lutheran Church, KenoshaSt Matthew Lutheran Church, PalmyraSt Matthew Lutheran Church, WauwatosaSt Olaf Lutheran Church, RubiconSt Paul Evangelical Lutheran Church, Random LakeSt Paul Lutheran Church, KenoshaSt Paul's Lutheran Church, MilwaukeeSt Peter Lutheran Church, SheboyganSt Stephen The Martyr Lutheran Church, GreendaleThe Table, MilwaukeeThe Village Church, MilwaukeeTrinity Lutheran Church, CedarburgTrinity Lutheran Church, KenoshaTrinity Lutheran Church, South MilwaukeeTrinity Lutheran Church, West BendUnited Lutheran Church, RacineUnity Lutheran Church, BrookfieldUnity Lutheran Church, MilwaukeeVernon Lutheran Church, MukwonagoWellington Park Lutheran Church, MilwaukeeWhitnall Park Lutheran Church, Hales CornersZion Lutheran Church, AshippunMy congregation is not listed above or I am representing an organizationIf your congregation is not listed above or if you are representing an organization please list the name here. Registration typeI am a/an*The term “youth” means a voting member of a congregation who is age 18 or under at the time of election or appointment for service. The term “young adult” means a voting member of a congregation who is age 30 and under at the time of election or appointment for service. Youth - age 18 and under when elected or appointedYoung Adult - age 30 and under when elected or appointedAdult - over 30 when elected or appointedPlease enter your birthdate*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year2022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920I am registering as a*Active Rostered Ministers are currently serving under call, on leave from call or disabled. Voting Lay MemberNon-Voting ParticipantActive Minister of Word and SacramentRetired Minister of Word and SacramentActive Minister of Word and ServiceRetired Minister of Word and ServiceImportant Information about Zoom and Lumi technologyWe will be using a platform for Synod Assembly that integrates the Zoom platform with Lumi voting in one window. This system works best on a desktop or laptop computer. It is possible to join with a tablet or smart phone, however, the voting and zoom windows will be separate tabs and not integrated into one window. We strongly encourage the use of a laptop or desktop computer for the best experience.I will join Synod Assembly on desktop or laptop computer*YesNoIf you are unable to join Synod Assembly with a desktop or laptop computer, you may join with a tablet, smartphone or landline. You may also consider watching in a group, safely distanced, on a large screen with a separate smaller device for each voting member.I will join Synod Assembly by*Check all devices you will use. watching on a large screen, safely distanced using a tablet using a smartphone using a landline Cell phone or landline number*Enter the cell phone number or landline number you will use to join the meeting. We need this information to identify you in the meeting and confirm your voting credentials. If this is not provided, you may not be able to vote.Details about how I will join:Please share detailed information about how you will join Synod Assembly so we can help you prepare for this meeting.Media PolicyWe believe that using media of the Greater Milwaukee Synod and its members in our print and web publications fosters a greater sense of community. The Greater Milwaukee Synod will never post images with identifying information such as name, email address, address, or family members’ names. To learn more visit here.Payment2021 Synod Assembly $0.00 Payment choice*I will pay online with my credit or debit card for this registration onlyI will pay online with my credit or debit card for more than one registrationI will send a check to the synod officeotherPlease explain "other"*PayPal Invoicing is NOT available for single registrations. To pay for a single registration by credit card, go back to Payment Choices and choose "I will pay online with my credit or debit card for this registration only."If you wish to pay for more than one registration with your debit or credit card, we will send you a PayPal invoice via email. Please enter the email address for the invoice below and choose submit. Because we must make this invoice manually, it is not an immediate email to you. We will create this as quickly as possible.We are not able to create invoices for single registrations. Paypal will offer you an option to print a receipt.Send PayPal invoice FOR MULTIPLE REGISTRATIONS to this email address*It may seem redundant to enter your email for each person you're registering; however, doing so will help us tie the registrations together so we can create your invoice. Enter email Re-enter email (these fields must match) TO COMPLETE YOUR REGISTRATIONWhen you hit the submit button below you will be taken to Paypal to finalize your payment. You are not required to create a PayPal account to pay online. Simply choose "pay with credit or debit card" (see example image below).You will also receive an email confirmation with your registration information included. If these things don't happen, please contact us at 414-671-1212 so we can see if your registration processed. To complete your registration mail a check payable to the Greater Milwaukee Synod to: Greater Milwaukee Synod EVENT NAME PO Box 341695 Milwaukee, WI 53234 Please write the event name on the memo line of your check and include the names of everyone covered by the payment (see image below). When you hit the submit button below you will see a registration confirmation page and you'll also receive an email with your registration information included. If these things don't happen, please contact us at 414-671-1212 so we can see if your registration processed.CAPTCHA
