2021 Ecumenical Charismatic College for Bishops

 Registration Form

Date:

Please insert today's date

Please do not complete this form unless you have received official confirmation of acceptance into the program

Student Status (Check One)

Student Information:

First Name:

Last Name:

e-mail Address (required):

Phone Number:

Please include Area Code in the following format:  555 555 5555

Permanent Address:

Street Address 1:

Street Address 2:

City:

Zip Code:

State:

Mailing Address:

Street Address 1:

Street Address 2:

City:

State:

Zip Code:

Payment Information:

The cost of this program is $3,000 USD per year. Your initial payment of $1,000.00 is due no later than September 25, 2021.  You are expected to pay the remainder in installments that equal $1,000 every four months until the full tuition of $3,000 has been paid.  You are not completely registered until you have completed this form and your initial deposit is paid.  Online payments include PayPal fees.  All payments are non-refundable. Failure to make timely payments in accordance with this agreement will result in your forfeiture of any payments made along with revocation of access to the course

Upon submission of this form, you will be taken to a page where you can make your payments

I certify that I have read and understand the conditions of participation in this program and am agreeing to complete all payments in a timely fashion

Registration 2021