This registration is for our seminar with Chuck Pierce, Nov. 12 & 13.
NOTE:
Cost is $65, which includes a syllabus.
Personal Information:
First Name:
Middle Name:
Last Name:
Date of Birth:
Name of your home church:
Mailing Address:
Street Address:
City:
State:
Zip Code:
Contact Information:
Home Phone:
E-mail Address:
Class Signup:
Sign-up for workshop?
Yes
No
Will you need childcare?
Yes
No
Payment Method:
What method of payment will you be using?
Cash
Check
Credit Card
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info@destinybibleschool.com
