ADMI POWER BIBLE SCHOOL JULY 2023 REGISTRATION

POWER BIBLE SCHOOL REGISTRATION FORM

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Name*

Prefix

First

Middle

Last

Gender*

Male

Female

Place of Birth*

Date of Birth*

Email Address*

Phone Number*

Address*

City *

States/Counties/Provinces*

Countries*

Attach Passport Photograph

Name of Next of Kin (Emergency Contact)*

Emergency Contact Phone*

Spouse Gender

Male

Female

Spouse/Fiancée’s Name (if any):

Spouse Place of Birth

Spouse Date of Birth

Spouse Phone

Spouse Email

Are you born again?*

If yes, when?*

What is your vision, and how will PBS help you achieve it?*

How did you hear about Power Bible School?*

Reference's Name:*

Reference's Phone:*

Reference's Email:

Reference's Address:*

ID or Passport #*

Please Upload Copy of ID or Passport*

Please type the characters*

This helps us prevent spam, thank you.

This field should be left blank

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