EmailMe Form - SJCIBS 2019 Fall Semester Registration

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You may notify the owner and continue to submit the form.

Unique ID
Date *
MM / DD / YYYY
GENERAL INFORMATION
August 12 - October 7
*Class Time - Mondays, 6:00-7:00 pm and 7:15-8:15 pm
*Textbooks are available from the Santiago Bookstore or SJCIBS Registration Table
REGISTRANT
Name *
First Last
Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
Phone *
### - ### - ####
Email *
Name of Church Membership *
Pastor's Name *
COURSE #1
Course Title *
Course # *
Instructor *
Classroom *
COURSE #2
(as applicable)
Course Title
Course #
Instructor
Classroom
TUITION - $20 for one class OR $35 for two classes
All Online Registration payments are made through Paypal
Tuition Cost *
$ Dollars . Cents