Please register early! Any course with fewer than 6 pre-registrations is subject to cancellation.
Required books are not included in the tuition or registration costs. Not all courses will need a textbook.
Please print out this page and mail it to
Koinonia Bible College
5049 Ehret Road • Marrero LA 70072-5327
...or fax it to 504/328-1817.
If paying by Visa or Mastercard, fill out the information at right. If paying by check, please enclose the check, or bring it to the first class. Make your check payable to "Koinonia Bible College."
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List the name of each course you want to take.
- If you wish to audit any courses, please write "Audit" next to the name of each such course.
- Married couple discount: If your spouse is taking the same course as you, then for each such course, write "Discount" and your spouse's name. Your spouse must also do the same on his/her registration form.
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Add up your fees:
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Course fee: $50 per course, except $37.50 for each course to which the married-couple discount applies.
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Registration fee: $25, regardless of how many courses you are taking. Each student must pay a new registration fee each quarter.
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Late fee: $5, required if your 2007 fall quarter registration is not received by Monday, September 3.
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Total
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First name, middle initial, last name
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Street address, city, state, ZIP code
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Daytime telephone
including area code
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Evening telephone
including area code
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E-mail address
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Date of birth
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Male or female?
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If paying by credit card, complete the following:
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Type of card
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____Mastercard ____Visa
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Name on the card
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Card number
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3-digit code
from back of card
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Expiration date
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Authorization signature
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