Spiritual Education & Enrichment Registration and Grade Report Form

Course

Course Start Date

Course End Date

Instructor Name

Instructor Email Address

Church or Center Name:

Church or Center Mailing Address (PO Box or Street info only)

City

State

Zip Code

Church or Center Email Address:

Number of Students in the Class ($45 each student)

If you have more than 20 students, please complete this form again.

Student #1

Legal Last Name

Legal First Name

Middle Initial

Student's Email Address

Grade

Student #2

Legal Last Name

Legal First Name

Middle Initial

Street Address

Student's Email Address

Grade

Student #3

Legal Last Name

Legal First Name

Middle Initial

Street Address

Student's Email Address

Grade

Student #4

Legal Last Name

Legal First Name

Middle Initial

Student's Email Address

Grade

Student #5

Legal Last Name

Legal First Name

Middle Initial

Student's Email Address

Grade

Student #6

Legal Last Name

Legal First Name

Middle Initial

Student's Email Address

Grade

Student #7

Legal Last Name

Legal First Name

Middle Initial

Student's Email Address

Grade

Student #8

Legal Last Name

Legal First Name

Middle Initial

Student's Email Address

Grade

Student #9

Legal Last Name

Legal First Name

Middle Initial

Student's Email Address

Grade

Student #10

Legal Last Name

Legal First Name

Middle Initial

Student's Email Address

Grade

Student #11

Legal Last Name

Legal First Name

Middle Initial

Student's Email Address

Grade

Student #12

Legal Last Name

Legal First Name

Middle Initial

Street Address

Student's Email Address

Grade

Student #13

Legal Last Name

Legal First Name

Middle Initial

Student's Email Address

Grade

Student #14

Legal Last Name

Legal First Name

Middle Initial

Student's Email Address

Grade

Student #15

Legal Last Name

Legal First Name

Middle Initial

Student's Email Address

Grade

Student #16

Legal Last Name

Legal First Name

Middle Initial

Student's Email Address

Grade

Student #17

Legal Last Name

Legal First Name

Middle Initial

Student's Email Address

Grade

Student #18

Legal Last Name

Legal First Name

Middle Initial

Student's Email Address

Grade

Student #19

Legal Last Name

Legal First Name

Middle Initial

Student's Email Address

Grade

Student #20

Legal Last Name

Legal First Name

Middle Initial

Student's Email Address

Grade

Payment