SP Ongoing Practicum Registration

Registration Form - Practicum

Certificate in Spiritual Formation
Title
Full Name
First Name
Middle Initial
Last Name
Name to be used on Name Tag
Gender
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
E-mail
Phone Number

Area CodePhone Number
Phone Type
Phone Number

Area CodePhone Number
Phone Type
Church Membership
Denomination
Include my contact information on roster handout
Registration and Payment Options

A non-refundable, non-transferable deposit is required at the time of registration.
Total Practicum Fee is $420. Check the box below for what you would like to pay now.
Payment Type
Credit Card Type
Name on Credit Card
Credit Card Number
Expiration Date
Security Code
Please print a copy of this registration for your records before pressing SUBMIT.

You will receive a confirmation including a receipt within 2-3 business days.
Columbia Theological Seminary
The Center for Lifelong Learning
701 S. Columbia Dr.
Decatur, GA 30031
Phone: 404-687-4577
Fax: 404-687-4591
LifelongLearning@ctsnet.edu
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Registration Form - Practicum