Course Registration

 Please type or print. Fill out one form for each individual registering.

 Name                                                                                                                          

Address                                                            City                                        

Zip                             

Phone   (           )                        -                                 

Church Name: ____________________________________________________________________________

 REGISTRATION DEADLINE: October 1, 2007

Place a check mark in the first column beside the course you wish to register for.
 

For more information or to request an application packet, please call Bethany Hollingsworth at 317.635.3552, ext. 221, or email  bethanyhollingsworth@abc-indiana.org

There is a limited amount of scholarship funds available for students. Contact Bethany Hollingsworth about eligibility requirements and availability.

Cost per course is $120.00
Send your registration form and check to: