Please note:
- Your payment of R200 along with your application form secures your place on the course.
The cost is a contribution towards catering, and helps cover some of the running costs – we do not charge for ministry. - Please email your proof of payment to info@wholenessthroughchrist.org.za
[contact-form subject=”Course Application Form” to=”info@wholenessthroughchrist.org.za“] [contact-field label=”Which course are you applying to attend?” type=”select” required=”true” options=”29-30 June 2018, 17-18 August 2018, 5-6 October 2018, 23-24 November 2018″ /] Full Name:[contact-field label=”Full Name” type=”name” required=”true” /] Address:[contact-field label=”Address” type=”textarea” required=”true” /] Email:[contact-field label=”Email” type=”email” required=”true” /] Contact number:[contact-field label=”Contact number” type=”text” required=”true” /] Date of birth:[contact-field label=”Date of birth” type=”text” required=”true” /] Occupation:[contact-field label=”Occupation” type=”text” required=”true” /] How did you hear about Wholeness Through Christ?[contact-field label=”How did you hear about Wholeness Through Christ?” type=”textarea” /] CHURCH: Which church do you attend regularly?[contact-field label=”CHURCH: Which church do you attend regularly?” type=”textarea” /] HEALTH: Please give brief details of current medication and reasons for use:[contact-field label=”HEALTH: Please give brief details of current medication and reasons for use:” type=”textarea” /] GENERAL: Please add any other general points you feel would be helpful:[contact-field label=”GENERAL: Please add any other general points you feel would be helpful:” type=”textarea” /] [/contact-form]