Disciple Bible Study Registration

Name:

Address (street, city, state, and zip):

Home Phone Number:

Cell Phone Number:

Email:

Childcare:
yes
no

Children Names & Ages:

Are you:
interested in more information on Disciple
ready to register for Disciple
unable to participate this year; keep me posted for other opportunities
want to attend the August 30, 11:45 a.m. brief orientation session.
want to attend the September 6, 11:45 a.m. brief orientation session.

Need financial assistance:
yes
no

Comments or questions:

Please type the text below: