PROGRAM REQUEST FORM

 

HOST INFORMATION ALL FIELDS IN THIS SECTION ARE REQUIRED
Church or Organization Name
Street  Address
City
State
Zip Code

 

Program Coordinator
Contact Phone
  is this number home   cell  office
Contact Email
Phone number to use on promotional materials

 

PROGRAM INFORMATION ALL FIELDS IN THIS SECTION ARE REQUIRED
Program Title or Type
Dates Preferred SELECT THE START DATE YOU PREFER
First Preference    
Second Preference    
Third Preference    

 

FINANCIAL ARRANGEMENTS  
Program fees: $795.00
Materials fees: $5.00 per person
Travel expenses: 49¢ per mile round trip -or- Round trip airfare, car rental, shipping (if necessary)

Note: We will pay for our own motel and meals expense.
Deposit information:

CTM requires a $200.00 non-refundable deposit in order to hold your date. The balance of finances will be due upon completion of the program.

 

Please send your deposit within 2 weeks of submitting this form to:

 

Christian Training Ministries

PO Box 92

Greenford, OH 44422

 

FINAL INSTRUCTIONS

A signature is required to confirm your program. To digitally sign this contract, please check the box below and enter your name in the box to the right. This indicates that you understand the fees listed above are are authorized to initiate this contract.

 

I hereby verify that I am authorized to enter into this contract on behalf of the church or organization named above.

 

Name: