LEAP Classes
Life-Giving, Education, And, Personal Stability
Which class are you registering for?
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True Discipleship (Weekly beginning November 7th at 12:00 pm)
Basic Budgeting (3 Week Course Beginning November 5th at 12:00 p.m.)
Name
*
First Name
Last Name
Address (If homeless, enter NA)
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number. If no phone, please enter all zeros
Email
*
example@example.com
How did you hear about this course?
*
Gender
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Male
Female
Rather Not Answer
Are you homeless?
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Yes
No
Do you live alone?
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Yes
No, live with other family members.
No, but live with others outside of my family.
Do you currently have a job?
*
Yes
No
Submit
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