Fill out this form to WIN one of two hotel accommodations and registration to the Family Life Today Marriage Conference, which is  taking place March 14 - 16, 2003 in Visalia at the Radisson Hotel Visalia.  The deadline for entering the contest is March 7, 2003 and we will be announcing the winner on Monday, March 10, 2003.

Participants must be over 18 to enter.

Don't forget to hit the submit button when you're finished!

 
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Entry Form

  Name (His): 
  Name (Hers):
  Address:
(if unmarried, his goes here)

 
  2nd Address:
(if unmarried, hers goes here)
  Phone Number (His): 
  Phone Number (Hers):
  Alternate or Work Number: 
  2nd Alternate or Work number: