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Enrollment Form

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CHMJI Class
Registration

Please complete the form to enroll.

Name

Church Affliation

Date of Birth

Email Address

Church Home Location

Course Selection

Registration Date

Link to Your Previously Taken Courses

Code

Phone

High School Graduate

Do You Have a College Degree(s)

List All College Degree(s)

Have You Completed any Bible Institute Courses? Please List:

Street Address

Street Address Line 2

City

Region/State/Province

Postal / Zip code

Country

Postal / Zip code

We value inclusion and access for all participants and are pleased to provide reasonable accommodations for our program. Please contact Natosha D. Roberts via email at Barbados1stinstitute@gmail.com to make a reasonable accommodation request. Requests must be submitted in writing by July 19th. Do you require any accomodations?

Thanks for submitting!

Barbados First Jurisdiction COGIC
1137 Avon Ave SW
Atlanta, GA 30310
hello@barbadosfirst.org

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