Personal Details:

Title *

Name *

Surname *

Is your spouse going to attend? *

Yes
No

If you are unmarried please select ‘No'

Spouse Title *

Spouse Name *

Church / Ministry Name *

Involvement in Church *

Involvement in Church (Spouse) *

Course Details:

Register for *

Have you previously attended this course? *

Yes
No

Has your spouse previously attended this course? *

Yes
No

Have your Contact Details changed since your last attendance? *

Yes
No

Email *

Telephone *

Mobile *

Has your spouse’s contact details changed since last attendance? *

Yes
No

Email (Spouse) *

Telephone (Spouse) *

Mobile (Spouse) *

Payment Details:

Total Cost per Individual

Total Cost per Couple

Total Cost per Individual

Total Cost per Couple

Total Cost Individual Re-attendance

Total Cost Couple Re-attendance

Total Cost 1 re-attendance & 1 new

Total Cost Per Individual

Total Cost Per Couple

Total Cost per Individual

Total Cost per Couple

Total Cost 1 re-attendance & 1 new

Total Cost per Individual

Total Cost per Couple

Total Cost per Individual

Total Cost per Couple

Total Cost 1 re-attendance & 1 new

Cost Total per individual

Per Couple

Total Cost per Individual

Total Cost per Couple

Total Cost per Individual

Total Cost per Couple

Total Cost 1 re-attendance & 1 new

Per Individual

Per Couple

Per Individual

Per Couple

Method of payment *

Cash
Bank Transfer (EFT)

Please tell us where you herd of this course:

Terms & Conditions

A non-refundable deposit of N$100.00 is required to confirm your registration (Except for The Style Factory N$50).
For courses that include manuals, but where registration is completed after registration close, as indicated on the itinerary, participants will not receive a manual.
Course, seminar and training itineraries and fees are subject to alteration without notice at the discretion of Lion of Judah Ministries.
Right of Admission Reserved.

I agree to the above Terms & Conditions *

I agree

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