If you desire to enroll yourself or another person in one of our courses, complete this form.

Name of Person to Enroll *

Institutional ID Number *

Name of Facility *

Housing *

Facility Address *

City *

State *

Zip *

Select Desired Course(s) *

Sense of Self

Sense of Family

Parenting Matters

True Freedom

Christian Marriage Skills

The Christian Woman

Attitudes & Behaviors

Christians Against Substance Abuse

The FamilyNet Series

The Seeker Bible Study Series

Prisoners of Christ

Managing My Anger

Christians Against Sexual Addiction

Managing My Dollar

Children's Edition

Language Preferred *

English

Spanish

If enrolling a family member or friend, describe relationship *

If enrolling a child (age 5-12), indicate age and/or school grade *

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Last Name