Pure Heart Atlanta REGISTRATION
NOVEMBER 6th to 8th, 2019
Email address *
First Name *
Your answer
Last Name *
Your answer
Phone Number *
Your answer
Address *
Your answer
Relationship Status *
Age *
Do you attend a Bible Believing Church? *
If you answered 'Yes' in the previous question, please state the name of the Church. *
Your answer
Do you believe in our Lord Jesus Christ? *
If you answered 'Yes' in the previous question, do you pray in tongues? *
Reason for applying *
Please tell us in not more than 200 words how you believe this program can help you.
Your answer
Please indicate which course(s) you have taken with us *
Required
I certify that my answers are true and complete to the best of my knowledge. I agree to pay a tuition fee of $500 before the commencement of The Pure Heart Atlanta. *
Required
I agree to attend ALL the sessions of The Pure Heart Atlanta, and participate fully in all tasks and assignments given. *
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