register chilliwack

Personal Information

First Name *Please fill the required field.

Last Name *Please fill the required field.

Date of Birth *Please fill the required field.

Citizenship *Please fill the required field.

Gender *

Male

Female

Please fill the required field.

Marital Status *

Single

Married

Separated

Divorced

Please fill the required field.

Contact Information

Address *Please fill the required field.

City *Please fill the required field.

Province *Please fill the required field.

Postal Code *Please fill the required field.

Phone *Please fill the required field.

Type *

Mobile

Home

Work

Please fill the required field.

Email *Please fill the required field.

Academic Information

What High School did you graduate from? *Please fill the required field.

Province *Please fill the required field.

Year of Graduation *Please fill the required field.

Do you have any post-secondary education? If so, please list.

Faith Journey

When were you born again? *Please fill the required field.

How do you practice and profess your faith? *Please fill the required field.

How does your faith impact your everyday decisions and activities? *Please fill the required field.

Why are you interested in participating in this program? *Please fill the required field.

Church Information

What church are you presently attending, and how long have you been going there? *Please fill the required field.

What is the name and contact information of your pastor? *Please fill the required field.

Which ministry or programs are you currently involved in at your church and in what capacity? *Please fill the required field.

This program involves in-class sessions, a mentorship/internship track, book reading, and assignments. How many hours are you realistically able to allocate to the program each week? *Please fill the required field.

Program Fees

We are able to offer all 10 courses for $100.00/course. These fees can be paid all at once up-front or in 4 separate instalments over the year.

Is the cost of this program going to be a financial challenge for you? *

No

Yes

Please fill the required field.

If you have any questions about the Victory Leadership Program please contact us at:
Email: leadership@vccfasttrack.ca
Phone: +1 (403) 286-8337

Please Note: A pastoral reference form will be sent to your pastor for him to complete.