Prophecology Registration

MPBP

Title - Please Select One*

Fledgling Age*

Name*

First Last

Enter Your Street Address*

Street Address City State / Province / Region ZIP / Postal Code Country

Home Phone:

Cell Phone:*

Email*

Book of the Month Subscriber:*

Yes
No

MasterMind Subscriber (paid or paying $5000):

Yes
No

I am attending the 2-Day Advance Training ONLY for P.O.M.E “Initiates or Neophytes” on: (Please check all that apply)

February 21st
February 22nd

NOTE: Advance training for ALL Initiates and ONLY for the first 30 Neophytes. Hotel check-in date Wednesday 2/20/19 at 3:00 PM

For 2-Day Advance Training, I’m requesting

Shared room with another POME member (paid or paying $750 rate)
Private room (paid or paying $1100 private room rate)

Roommate for 2-Day Advance Training*

I need a roommate.
My confirmed roommate is:

Roommate's Name*

First Last

Roommate's Cell Number*

I am attending the Prophecology Conference on: (Please check all that apply)

February 22nd
February 23rd
February 24th

For Prophecology Conference, I’m requesting

Shared room with another POME member
Private room (paid or paying applicable private room rate $750)

NOTE: Resort check-in date for Prophecology Conference is Friday, 2/22/19, at 3pm; check-out date is Monday, 2/25/19, at 12Noon.

Roommate for Prophecology Conference*

I need a roommate.
My confirmed roommate is:

Roommate's Name*

Roommate's Cell Number*

I am requesting a room with: (Check your choice)

One bed
Two beds

I am requesting a bathroom with: (Check your choice)

Bath tub with shower
Walk-in shower only (not handicap bath)
Roll-in shower only (ADA bathroom)

NOTE: The bed and bathroom requests are NOT guaranteed.

I am a

Male
Female

I am a

NON-Snorer
Snorer

I am a

NON-Smoker
Smoker

My meal choice for Prophecology Conference is

No Restrictions
Poultry Only
Fish or Vegan Only

For additional information or payment, contact a Zoe Ministries moderator at 888-831-0434.

Travel Information:

Note: Travel to Puerto Vallarta, Mexico Airport Code: (PVR)

Date of Arrival to PVR*

Arrival Time to PVR*

:

Airlines Name*

Flight Number*

Date of Departure from PVR*

Departure Time From PVR*

:

Airlines Name*

Flight Number*

Emergency Contact Information:

Name*

First Last

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Cell Phone*

Name

This field is for validation purposes and should be left unchanged.