SLT - Repeat Facilitator

SLT Application: Repeat Facilitator

Intensive Location
Which Intensive would you like to register for?*
Contact Info
*Name:
*Email:
Address:
City:
State:
Zip:
Phone:
Fax:
Work:
Mobile:
Date of birth:
*Facilitator's name:
*Facilitator's email:
Your Church
*Church name:
Address:
City:
State:
Zip:
*Pastor's name:
Your Family
Spouse’s name:
Siblings’ names:
Children’s names:
About You
Employment:
Part Time
Full Time
Graduate Information
Date graduated:
Housing and Transportation
Please choose from the following options:
I will be staying in a hotel, or have made other arrangements. I do not need housing or transportation.
I would like to request housing or transportation.
To find hotels in the area, see the Host Church information on the Intensives page, or contact the SLT office or the Host Church office for further assistance.
To request housing and/or transportation, please enter the following info.
If you are traveling by plane, please enter flight details. If you are driving to the Intensive, please provide the day and approximate hour you will be arriving and leaving so your host may plan accordingly.
Arrival:
Airport:
Airline:
Flight #:
Date:
Time:
Departure:
Airport:
Airline:
Flight #:
Date:
Time:
Transportation:
I will have a car.
I would like to request transportation.
Housing:
I wish to be housed in a local home.
Names of other Students or Facilitators with whom you wish to room:
Any allergies (pets? foods?), medical, or dietary instructions of which we should be aware?
Other information we should know?
Comments
Other comments:
Payment
Card Type:*
Visa
Mastercard
Discover Card
Card Number:*
Name on Card:*
Card Expiration:*
/
Submit Application
To pay by check, please print and complete the following documents:
  1. Your application (just print this page)
  2. The medical release form
  3. A check for the $150 Intensive fee made payable to SLT

And then mail all of the above documents to: SCS, Attn: SLT, 1260 N Dutton Ave Suite 242, Santa Rosa, CA 95403.


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SCS Media Center

New Mailing Address:

SCS
1260 N Dutton Ave Suite 242
Santa Rosa, CA 95401

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