Life Solutions Counseling and Training Center

Biblical Counselor Registration Form

Life Solutions Counseling and Training Center

11701 Old St. Charles Road

Bridgeton, MO 63044

314-291-1762 www.lsctc.org lifesolutionscenter@yahoo.com

Please complete registration and pay non-refundable $35 fee below or print and mail in with check or money order payable to Life Solutions Counseling Center.

First Name: *

Last Name: *

Date of Birth *

Gender *

Module *

Email Address:

Add

Home Phone #: *

( )

Cell Phone #:

( )

Please select preferred phone for contact.

Address

Street Address *

Address continued

City *

State *

Zip *

Personal Information

Have you confessed Jesus Christ as your Lord and Savior? Using Scripture, please share your salvation experience below being sure to include when, where, etc.

Church Name *

Pastor's Name *

How many rooms do you need?

Do you require any special accommodation?

Denomination *

Are you a member *

Life Solutions does not prepare students for state, national qualifications, or licensure. It is our belief is that Biblical Counseling is a ministry of the church, rather than a profession that is licensed by the state.

How did you hear about Life Solutions? *

Need assistance with this form?

Personal Reference Form.rtf
Size : 0.028 Kb
Type : rtf

Important!!! Please Read!!!

Please be sure to complete the registration form by clicking the button at the bottom of the page AND pay by choosing your payment options through the PayPal link located directly under the registration form.

The $35 Registration Fee is due with submission of application (online or mailed). All Module Fees must be paid on or before the first day of class. All Registration Fees are non-refundable.

If you are a liscensed minister or an attender of Gateway Central, please call the office @ 314-291-1762 or email Tami Thompson for special discount on tuition.

Counselee Resources

Consent Form.rtf
Size : 13.965 Kb
Type : rtf

Personal Data Form.rtf
Size : 0.027 Kb
Type : rtf

PUT OFF PUT ON LIST.rtf
Size : 0.235 Kb
Type : rtf

If you would like to donate to Life Solutions Counseling and Training Center, simply click the link below and select your easy and secure payment options. Thank you for helping us share the transforming TRUTH of the Word of God with others!