Course Registration Form

Rhema Studies of Theology Association

Student Registration Form
Student Name

First Name Middle Name Last Name
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Student E-mail
example@example.com
Mobile Number
Phone Number
Work Number
Church Name
Pastor's Name

First Name Last Name
Church Phone Number
Please enter a valid phone number.
Program Please Select One

Certificate Diploma
Please Note Non-refundable registration $75.00 is required Per Program with the completed application form.

RSOTA Office Number: 647 498-7425, www.rsota.org, Email dr.lewis@rsota.org
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Rhema Studies of Theology Association