Christ Church
Wednesday, September 08, 2010

Adult Registration

 
FALL SEMESTER: SEPTEMBER 2010 - JANUARY 2011        
                                                                    Date 
 
PERSONAL INFORMATION:
  
First name        Last name 
 
Home address   
 
City    State    Zip 
 
Home phone     Cell   
 
Email 
(Only give us your email address if you regularly check your email, if you do not list an email address we will make sure to call or mail you any needed information).
 
Date of Birth   (mm/dd/yyyy)     
 
How did you hear about The Amazing Collection? 
 
Check here if you attend Christ Church
 
 Bible Knowledge:  None  Some  Fairly Familiar
 
EMERGENCY INFORMATION:
Name of local contact person
 
Phone(s)  Relationship
 
ADULT REGISTRATION INFORMATION:
Please check the class you are registering for:
Tuesday Morning  Wednesday Evening  
 
Check here if you need a scholarship
 
Check here if you would like to provide a scholarship
 
Please have payment ready when you pick up your books.
Cash or check payable to Christ Church
 
PLEASE CLICK HERE TO SUBMIT ADULT REGISTRATION.