2027 Conference Registration - HGAAA National Women’s Department

A registration form is required for each individual.

For more information, please contact Dr. Victoria Gray or Tiffany LaMeia @256-566-9582 or 256-642-9432

Your order

Billing details

First Name

Last Name

Country / Region

Mailing Address

Apartment, suite, unit, etc. (optional)

City

State

ZIP

At least one phone number is required. Please provide your Home, Work, or Cell number.

Phone (Home) (optional)

Phone (Work) (optional)

Phone (Cell) (optional)

Home Church *

Church City *

Church State*

Pastor's Name *

Your Title *

Additional information

Additional Notes (optional)

Your order

Product	Subtotal
2027 Conference Registration × 1	$65.00
Subtotal	$65.00
Total	$65.00

PayPal / Venmo

Pay with PayPal or Venmo. Select your preferred payment method below.
Debit & Credit Cards

Cardholder Name
Card number *
Expiry (MM/YY) *
CVV *
Zelle

Please send the following amount: {order_total}

Important: Your registration will be submitted first. Payment through Zelle is not completed when you click the “Place Order” button.

After you submit your registration, your Order Number will be created. Please use this Order Number as the payment reference when completing your Zelle payment.

Zelle payment instructions are provided below. You can scan the QR code or use the clickable link to access Zelle or your banking app.

Please make sure to use your Order Number as the payment reference when making your payment. This will help us match your payment to your registration.

Your registration will remain On Hold until your Zelle payment has been received and verified. Submitting your registration does not mean that payment has been completed.

After completing your payment, please retain your Zelle payment confirmation. If you receive a Zelle transaction or confirmation number, you may provide it after submitting your registration.

Your payment will be reviewed, and your registration will be updated to Completed once the payment has been verified.

Thank you!

Scan QR
Important
Please use your Order Number as the payment reference when completing your Zelle payment. Your Order Number is shown above.
Link
https://enroll.zellepay.com/qr-codes?data=eyJuYW1lIjoiVklDVE9SSUEgR1JBWSIsInRva2VuIjoiamJsZXNzakBob3RtYWlsLmNvbSJ9
Account Name
Victoria Gray / Higher Ground National Women
Email
jblessj@hotmail.com
Pay by Check

Please complete and submit your registration order first.
After submitting your order, please send the following amount by check: {order_total}

Please make the check payable to:
Higher Ground National Women Dept.

Please mail the check to:
HGAAA National Women Planning Committee
Attn: Dr. Victoria Gray
3211 Vicksburg Dr. S.W.
Decatur, AL 35603

Important: After completing your registration, please write down your order number. You will need to include this order number on the check so that we can match your payment to your registration.

Your registration will remain pending until the check is received and the payment has been verified. Once the payment is confirmed, your registration will be approved.

You do not need to enter the check number or provide any additional payment information online.

Thank you!

Please make the check payable to
Higher Ground National Women Dept.
Please mail the check to
HGAAA National Women Planning Committee | Attn: Dr. Victoria Gray | 3211 Vicksburg Dr. S.W. | Decatur, AL 35603

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