Ordained Life Registration Form
Full Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Format: (000) 000-0000.
E-mail
*
example@example.com
Church Affiliation
*
Senior Pastor
*
What area of ministry are you being ordained in?
*
Have you been given authorization by your Senior Pastor to take this course?
*
Yes
No
Registration Cost
prev
next
( X )
Registration Fee
Non Refundable Fee
$75.00
$
75.00
Payment Methods
Choose from one of the PayPal options to
make your payment.
Print
Submit
Should be Empty: