RegisterRegina

Personal Information

Legal First Name*

Legal Last Name*

Preferred Name (if applicable)

Date of Birth*

Citizenship*

Gender* Male
Female

Marital Status* Single
Married
Separated
Divorced

Contact Information

Address*

City*

Province*

Postal Code*

Phone*

Type* Cell
Home
Work

Email*

Academic Information

What High School did you graduate from?*

Province*

Year of Graduation*

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

Faith Journey

When did you get born again?*

How do you practice and profess your faith?*

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

Why are you interested in participating in this program?*

Church Information

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?*

Briefly share why you want to be part of this training program.*

This program involves in-class sessions, a mentorship/internship track, book reading, and assignments. How many hours are you planning to allocate to the program each week?*

Program Fees

Because this is our first-year pilot program, we are able to offer all 10 courses for $100.00/course which is a 50% savings. 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 at the Regina location will contact you shortly.