Registration Form

Name of Programme: LEADERSHIP TRAINING FOR PASTORAL OUTREACH

Dates: January 20, 2007 to June 2009

Fee: $900 per year in advance; or $300 at start of each term

Name of Participant: …………………………………………………… Male ___
(Block letters) Female ___

Address: ………………………………………………………………………………………

Tel Contact: Work: ………………..…… Home: ……….……….. Cell: ……………...

E-Mail: ……………………………………………………………………………….………

Age: ____ Under 30 yrs ____ 31-50 yrs ____ Over 50 yrs

Parish/Community: …………………………………………………….………………………………

Brief Description of …………………………………………………………………….…………………

Community: …………………………………………………………..……………….…………

……………………………………..……………………………………….………

How will this 3-year …………………………………………………………………………..…..……...

Programme help you:

……………………………………………………..………………………..……...

……………………………………………..………………………………..……..

Programme/s completed ___ Liturgy School ___ School of Communications

in the last five (5) years: ___ School of Evangelization ___ Bible Institute

___ Other (please specify)…………………………………………………

……………………………………………………………….……………

Education: ___ Secondary ___ Tertiary

Special Dietary Needs (re Lunch): …………………………………………….………………………….

Method of Payment: ___ $900 per year ___ $300 per term ___ Enclosed

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(Signature) (Date)