Impact Missions Course in Bulgaria / PEM
REGISTRATION FORM
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Email *
Name / Last name, First name  *
Gender *
My phone number *
Contact phone number *
Profession *
Nationality *
Date of Birth *
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Address
Street address, City, Country 
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Motivation for applying to the course
Explain your reasons to apply to become a student on the course 
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Church information
Name of church, denomination, name and email of your pastor or leader
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I will request a recommendation from my pastor/leader for my participation in the Impact Missions Course in Bulgaria and send it/have it sent to impact@pem.pef.eu 
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Languages I speak
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Allergies
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I understand that my registration is complete once my course fee, 30€ is paid and proof send to impact@pem.pef.eu.
(Accommodation and food are not included in the price.)

NAME: Pentecostal European Mission
IBAN: DE61 5009 2100 0001 7704 11
BIC: GENODE51BH2

Address:
Chaussée de Waterloo 47,
1640 Rhode-St-Génèse,
BELGIUM

When you make a donation:
*Impact Missions Course 2025, full name.

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I will take a traveller's insurance for the duration of the course  
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Data protection: I agree that my data will be collected and processed for the organization and implementation of this and future Impact Missions Course. My information will not be forwarded to third parties. I can revoke this consent in writing at any time.
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I allow Impact Missions Course to use all photo and video materials relating to my person without charge for all types of public relation purposes, including the publication of their photos and videos on the Impact  web pages, Instagram and Facebook. The consent form can be recalled in writing at any time. Any material already used prior to such notification are not affected. 
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A copy of your responses will be emailed to the address you provided.
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