Youth Leader's Practicum Registration
Fill out the form carefully for registration
Name
*
First Name
Middle Name
Last Name
E-mail
*
example@example.com
Mobile Number
*
Phone Number
Work Number
Church
*
Context of Youth Involvement
*
example: Youth Leader, Volunteer, Youth Pastor etc...
How did you hear about this training?
My Products
*
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Youth Leader's Practicum Tuition
This does not include book costs.
$
100.00
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Practicum Church Cost (must pay with Church Credit card)
This does not include book costs.
$
75.00
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Credit Card
Submit
Should be Empty: