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Young Ladies Discipleship Online version Registration
Registration form for the 2021 Discipleship Program for young Ladies to be held February 2 through March 1, 2021 morning sessions via online forum.
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Email
*
Your email
Applicant's Full Name
*
Your answer
Age (as of February 2, 2021)
*
Choose
15 (with supervision of female, adult guardian)
16 (with supervision of female, adult guardian)
17 (with supervision of female, adult guardian)
18
19
20
21
22
23
24
25
26
27
28
29
30
Address: Street, City, State, Zip code
Your answer
Phone number (self)
*
Your answer
Parent (or Guardian) Full Name
Your answer
How did you hear about this discipleship program?
*
Your answer
I am registering for the online portion of the ladies discipleship program. I have internet access and am able to participate in the classes.
*
Yes
No
Other:
Required
Payment of the program fee will be made by the following method:
*
PayPal
Credit/Debit Card
Check
Other:
Any additional questions or comments:
Your answer
I will abide by the event's rules and guidelines (refer to
www.loveandpurity.com/event-guidelines
for rules and guidelines)
*
yes
Required
Submit
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