Basic Registration

Your Name *
Email *
Church Name *
Address *
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry
Contact Person *
Phone *
How many people are you registering? *
Next Steps There are currently two ways to submit payment. If you're paying online, go ahead and complete this form, and go to our payments page and follow the instructions there.
If you're mailing a check, please send payments to the address below:

Unique Student Ministries
P.O Box 30100
Houston, TX 77249

Checks and Money Orders Payable: USM

Please enter any two digit number for verification (just so we know you're not a robot). *example: 12
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