Advanced Registration

Legal First Name*

Legal Last Name*

Preferred Name (if applicable)

Date of Birth*

Citizenship*

Gender* Male
Female

Marital Status* Single
Married
Separated
Divorced

Address*

City*

Province*

Postal Code*

Phone*

Type* Cell
Home
Work

Email*

What High School did you graduate from?*

Province*

Year of Graduation*

Do you have any post-secondary education? If so, please list below.

When did you get born again?*

How does your faith impact your everyday decisions and activities?*

Why are you interested in participating in this program?*

What church are you presently attending, and how long have you been going there?*

What is the name and contact information of your pastor?*

Which ministry or programs are you currently involved in at your church and in what capacity?*

We are able to offer all 10 courses for $100.00/course. These fees can be paid all at once up-front or in 4 separate instalments over the year.

Is the cost of this program going to be a financial challenge for you?* Yes
No

If you have any questions about the Victory Leadership Program please contact us at:
Email: leadership@vccfasttrack.ca
Phone: +1 (403) 286-8337

Please Note: A pastoral reference form will be sent to your pastor for him to complete and send back to us.

Thank you for filling in this Registration Page information.

Our facilitator will contact you shortly.

God Bless and have a wonderful day!