Registration Form – GoCitizen

Contact Information:

First and Last Name (required)

Your Email (required)

Address

City

State

Zip

Country

Home Phone

Cell Phone

Work Phone

Date of Birth (mm/dd/yyyy)

Your Church:

Church Name (required)

City

Pastor's Name

Your Family:

Spouse's Name

Children's Names

About You:

Level of Completed Education

Employment

Position

Business Type/Industry

Extra-curricular activities

Years you've been serving Jesus

What I hope to receive from my participation in the School of Kingdom Citizenship

Do you already know someone who is a trained Facilitator that you would like to facilitate you? If so, please indicate their name

Please write a short essay in this box (approx 100 words) on "Why I Want to be Trained":*

How did you find out about GoCitizen?

Student Agreement:
As a student, I agree to fulfill my responsibilities to the curriculum and to my Facilitator by participating in all required activities and staying accountable to finish my assignments. For networking purposes, I authorize the release of my email address to fellow Students & Facilitators only.

Have you attended an Intensive/Transforum Event?
YesNo

I agree to fulfill the Intensive/Transforum Event requirement for the School of Kingdom Citizenship, attendance before the course or within the next 18 months. NOTE: Graduation status/completion of the school is contingent upon attendance of an event.

PAYMENT: Once your enrollment form is submitted, please complete payment. Your enrollment is not complete until full payment has been made OR you have submitted a Payment Plan and made a deposit.

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