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Registration Form
Please Print Registration Form: Copy and print this form.
Name:_______________________________________________________________________
Address:_____________________________________________________________________
City:________________________________________________________________________
State & Zip:__________________________________________________________________
Home Phone:_________________________________________________________________
E-mail:______________________________________________________________________
Church Name:________________________________________________________________
Address:____________________________________________________________________
City, State & Zip:_____________________________________________________________
Church Phone:________________________________________________________________
Prerequisites
1. Please send current photo of yourself with this Preregistration Form for your Student File. There will be a $2.00 non refundable photo charge if you do not provide one with preregistration form.
2. Have you already completed “Ministering Spiritual Gifts”?
When & where?____________________________________________________________
_________________________________________________________________________
3. Your Senior Pastor’s signature is required here to enroll.
(Pastoral Reference will also be sent to Sr. Pastor)
_________________________________________________________________________
4. Print Pastor’s name here:
_________________________________________________________________________
5. Who from the ECC faculty have given you their blessing before enrolling? (See list of staff members.)
_________________________________________________________________________
6. Complete the Student Application and return with this form.
Registering For:
School of Prophetic Prayer - Discount Coupon Code: _______ School of Prophetic Prayer - $245.00:________
Total Due - $________
(Must have all prerequisites complete to avoid being denied enrollment)
Paying by credit card:
Please Circle: Discover / Visa / Master Card
Discover/Visa/Mastercard # ____________________________________________
Exp. Date ____/____ V-code____ Amount charged ___________
Name on card: ______________________________________________
Signature:__________________________________________________
Call-in registration by credit card payment:
740-725-0300, 740-389-2910 ext.24, FAX 740-386-2205
Email registration by credit card payment: Eagle Christian College
Paying by check:
Make checks payable to Eagle Christian College
There is a $30.00 Service Charge on all returned checks.
Please copy, print and mail this form along with your registration fee to:
Eagle Christian College 1550 Richland Rd. Marion, OH 43302
Office use only:
Date__________________ Clerk initials______________ Dollar Amount_______________ Payment method_________________
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