SOTH In-Person Registration Form 2025

In-Person School of the Heart Class

Tuesdays 6:30-8:30 EST
Name*

First NameLast Name
Age*
Gender*

MaleFemale
Date of Birth*

MonthDayYear
Date
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Occupation
Marital Status *
If you are married or dating, is your spouse or significant other registering? If Yes, what is their name?

Tuition Payment OR Registration Fee*

Full Tuition : One time paymentNo Registration Fee Necessary

$350.00 Quantity

Save My Spot! : Registration Fee$25 now, payment plan options will be emailed to you.

$25.00 Quantity

Enter coupon

Total

$0.00

What do you want to get from School of the Heart?

We are so glad you are here! Tell us more about why mental and emotional health are important to you in this season. What are you hoping School of the Heart will add to your life?
Please explain why you want to be a part of School of the Heart this year? What do you hope to gain during your time with us? Please include the areas of your heart and life where you are noticing a growing awareness and hunger for change in. *
During your time in School of the Heart, if we deem it necessary, would you be willing to go to Counseling?*

YesNoUnsure
Congratulations!

We are so excited you are joining us.
If you have any questions please contact Ben Miller at {Ben@elmdm.com}.
Behold, You desire truth in the inward parts. And in the hidden part You will make me to know wisdom. Psalm 51:6
Please verify that you are human*
School of the Heart

Registration Form 2025
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In-Person School of the Heart Class