AMERICA COME BACK TO GOD BIBLE INSTITUTE REGISTRATION FORM

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Full Name

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Email

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This address will receive a confirmation email

Phone

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Full Mailing Address

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Academic Information

Degree

Please select one option.

Th.B B.R.E. Th.M M.R.E. D.R.E. ST.D. D.D.

Auditor

Please select one option.

Sit In Diploma Certificate Senior Citizen In-House Zoom

I WILL NOT GIVE OUT THE ZOOM PHONE # AND PASSCODE TO OTHERS.

*

Please select all that apply.

Yes

Education History

High School Attended, # of Years

College Attended, # of Years

Did you receive a degree? If yes, Date & Type of Degree

Biblical Education? If so, what school? Dates, Type of Degree

Course Name & Course Fee

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REGISTRATION FEE -- $25.00: $15.00 for Senior Citizens (Non-Refundable)

*Course FEE for 12 Week Courses - $75.00: $60.00 for Senior Citizens

Pay the Registration and/or Course Fee by Clicking 'Give' and Entering the Dollar Amount and Card Information.

Description

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