Student Registration ADT 2024 Student Information ADT 2024 Advanced Discipleship Training 2024-2025 Date Name(Required) First Last Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Email(Required) Best Contact Phone#(Required)Date Of Birth Marital Status Single Married Divorced Widowed Separated Name of Spouse First Last Emergency Contact #1 Plus Phone #OccupationChurch Member? Yes No Church Name and DenominationChristian Background and HistoryBriefly, how and when did you come to Christ?What is your goal in taking ADT?Have you recieved Discipleship counseling and/or counseling in the past?(Required) YES NO Briefly, explain your experience.Do you have Christian Ministry experience?(Required) YES NO Briefly, explain your experience.AgreementsInformation Agreement(Required) I Agree I Do Not Agree I AGREE THAT I WILL KEEP ALL PERSONAL INFORMATION ABOUT PARTICIPANTS IN ADVANCED DISCIPLESHIP TRAINING OR WOMEN OF GRACE CLASSES, AND THEIR LIKENESS, IN STRICT CONFIDENCE, WHETHER I PARTICIPATE ON THE PHYSICAL PREMISES OF GRACE LIFE INTERNATIONAL, ONLINE, OR VIA RECORDINGS. Name First Last Date Sharing Agreement(Required) I Agree I Do Not Agree I UNDERSTAND THAT ADVANCED DISCIPLESHIP TRAINING AND WOMEN OF GRACE CLASSES ARE RECORDED AND CAN BE USED BY GRACE LIFE INTERNATIONAL FOR OTHER TRAINING OR PROMOTIONAL PURPOSES. BY SIGNING BELOW, I UNDERSTAND, AND GIVE PERMISSION TO GRACE LIFE INTERNATIONAL TO SHARE VIDEOS RECORDINGS, AUDIO RECORDINGS AND/OR PICTURES OF ME IN ORDER TO SHARE GRACE LIFE TEACHINGS WITH OTHERS OR TO PROMOTE THE GRACE MESSAGE WITHOUT ANY FINANCIAL OR OTHER COMPENSATION.Name First Last
