If you have reached this page then you have decided to opt out of the online payment option provided by CCIW Disciples
Please Write a check payable to “CCIW Disciples” and mail it to:
Regional Office Bloomington, IL
Address: 401 W Jefferson St. Bloomington IL, 61701
Thanks For Deciding to attend an Event Sponsored by CCIW Disciples
You will receive and email confirmation of your application with the full form included in the email.