Visiiion Christian Devotional Class Student Registration
Credit Card
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Confirm Email
*
example@example.com
Birthdate
*
-
Month
-
Day
Year
Date
How did you hear about Tiffany Buckner?
*
YouTube
TikTok
Instagram
Facebook
I Personally Met Her
Through a Friend
Other
Do you currently have a Facebook page?
*
Yes, I do.
No, I do not, but I am willing to establish one so that I can join the community.
List three of your strengths.
*
List three of your weaknesses.
*
List any additional details that you believe we should know about you.
*
Registration
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Devotional Class Registration (Standard)
$
299.00
Quantity
1
2
3
4
5
6
7
8
9
10
Devotional Class Registration (Early Bird)
$
199.00
Quantity
1
2
3
4
5
6
7
8
9
10
Item subtotal:
$
0.00
Devotional Class Registration (Star Student)
$
399.00
Quantity
1
2
3
4
5
6
7
8
9
10
Item subtotal:
$
0.00
Songwriting Class Registration
$
299.00
Quantity
1
2
3
4
5
6
7
8
9
10
Item subtotal:
$
0.00
Mass Producer's VCBCC Registration
$
1,799.00
Quantity
1
2
3
4
5
6
7
8
9
10
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Submit
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