EmailMe Form - 2017 Next Gen. OBC KIDS

Student Name #1/학생 이름 *

Grade/학년 #1 *

Additional Students

Student Name #2

Grade/학년 #2

Student Name #3

Grade/학년 #3

Guardian Name/보호자 성함 *

Email *

Phone *

### - ### - ####

신청 과목 *

OBC KIDS

신청 방법 *

Student 1 ($20.00)

Student 2 ($20.00)

Student 3 ($20.00)

Name on Card (영문) *

First Last

Submit 을 누르시면, Paypal Payment Page 로 이동하게 됩니다. 카드 정보를 바로 입력하시면 됩니다.

Billing Address (카드 청구지 주소) *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

By clicking the Submit button, I give authorization to NJ Onnuri Community Church to charge my credit card in the amount $20 to enroll in "2017 Bible Academy."

Other Request/Comments