The Emmaus Institute for Biblical Studies · 2023 Fall Course: Heaven Help the Home

Discount Code

How many people would you like to register? *

Registrant #1 Fee (All are welcome to attend classes, regardless of financial situation. Please enter the amount you are able to pay, if less than the recommended amount.) *

$200 - Regular

$150 - Religious/Clergy

$

Discounted Registrant #1 Fee *

$100

Registrant #1 Course Section *

In-Person (Includes Online)

Online Only

Name *

Prefix

First Name

Last Name

Suffix

Email (contact information is used only for Emmaus communications - you may opt out any time) *

Verify Email *

Phone Number *

Address *

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Age (statistical purposes only) *

Place of Worship *

If "Other", enter the name and city/town of your place of worship. *

Parish *

How did you find out about this course? Please be specific. *

Please Complete the Following Information for the Second Registrant

Registrant #2 Fee (All are welcome to attend classes, regardless of financial situation. Please enter the amount you are able to pay, if less than the recommended amount.) *

$200 - Regular

$150 - Religious/Clergy

$

Discounted Registrant #2 Fee *

$100

Registrant #2 Course Section *

In-Person (Includes Online)

Online Only

Relationship to Registrant #1: *

Registrant #2 Name *

Prefix

First Name

Last Name

Suffix

Registrant #2 Email *

Verify Email *

Registrant #2 Phone *

Same Address as Registrant #1? *

Yes

No

Registrant #2 Address *

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Registrant #2 Age (statistical purposes only) *

Registrant #2 Place of Worship *

If "Other", enter the name and city/town of your place of worship. *

Parish *

Please Complete the Following Information for the Third Registrant

Registrant #3 Fee (All are welcome to attend classes, regardless of financial situation. Please enter the amount you are able to pay, if less than the recommended amount.) *

$200 - Regular

$150 - Religious/Clergy

$

Discounted Registrant #3 Fee *

$100

Registrant #3 Course Section *

In-Person (Includes Online)

Online Only

Relationship to Registrant #1: *

Registrant #3 Name *

Prefix

First Name

Last Name

Suffix

Registrant #3 Email *

Verify Email *

Registrant #3 Phone *

Same Address as Registrant #1? *

Yes

No

Registrant #3 Address *

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Registrant #3 Age (statistical purposes only) *

Registrant #3 Place of Worship *

If "Other", enter the name and city/town of your place of worship. *

Parish *

Please Complete the Following Information for the Fourth Registrant

Registrant #4 Fee (All are welcome to attend classes, regardless of financial situation. Please enter the amount you are able to pay, if less than the recommended amount.) *

$200 - Regular

$150 - Religious/Clergy

$

Discounted Registrant #4 Fee *

$100

Registrant #4 Course Section *

In-Person (Includes Online)

Online Only

Relationship to Registrant #1 *

Registrant #4 Name *

Prefix

First Name

Last Name

Suffix

Registrant #4 Email *

Verify Email *

Registrant #4 Phone *

Same Address as Registrant #1? *

Yes

No

Registrant #4 Address *

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Registrant #4 Age (statistical purposes only) *

Registrant #4 Place of Worship *

Parish *

If "Other", enter the name and city/town of your place of worship. *

Will you partner with Emmaus?

(Optional) Your tax-deductible gift helps advance the work of Emmaus by assisting those who can't afford to pay full registration fees, helping us give community presentations and retreats, and assisting with general operating expenses. Thank you!

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