Alpha Registration

Please enter your name *

First Name

Middle

Last Name

Please enter your address *

Address Line 1

Address Line 2

City

State

Postal Code

Telephone

To help us plan the small groups, please tell us your age:*

Marital Status (optional)

Married
Single

Please choose the Alpha course for which you are registering: *

Sundays, 8:30am, Arden Hills (Beginning January 29)
Tuesdays, 9am, Arden Hills (Beginning January 31)
Tuesdays, 6pm, Arden Hills (Beginning January 31)
Thursdays, 6pm, Roseville (Beginning February 2)

Childcare for ages 12 and under is available on Tuesday morning or evening only. If childcare is needed, please check YES and give names and ages of all children attending.* Yes
No

Child 1 Name:

Child 1 Age:

Child 2 Name:

Child 2 Age:

Child 3 Name:

Child 3 Age:

Special Requests:

Alpha