Assemblies of God Theological Seminary: NACBA Registration Form

Office of Continuing Education
Training Program in Church Business Administration

In Cooperation with:

Educating to Excel, Training to Serve

Registration Form

*Required fields.

Personal Information:

*Full Name:

*Address:

*City, *State, *Zip

*Home Phone:

*Email Address:

Church Information :

*Name of Church:

*Address:

*City, *State, *Zip:

*Office Phone:

*Fax Number:

*Email Address:

*Denomination:

*Job Title:

*Are you a member of NACBA?

Yes
No

Seminar Options

Seminar A ($300) Seminar B ($300) Seminars A and B ($575)

Payment Options

$100 Deposit $300 Full Payment $575 Full Payment

How do you plan to pay? Visa MasterCard Discover Check

If paying by check, please mail your payment to:

AGTS Continuting Education Office
1435 N. Glenstone Ave.
Springfield, MO 65802

If paying by credit card, complete the following:

Credit Card Number:

Expiration Month:

Expiration Year:

Card Security Code: What is the card security code?

Name as it appears on credit card:

Updated: Friday, January 25, 2013 8:37 AM