Head to Heart Registration “從腦到心”門訓課程註冊表

Step 2 of 3 步驟二

First name 中英文名字（如有英文名字）*

Last name 姓（請用拼音）*

Email 郵箱*

Phone 電話*

Address 1 地址 1*

Address 2 地址 2

City 城市*

State/Province 州（美國）/省份*

Zip 郵編*

Country 所在國家*

Select the course offering you would prefer 請選擇適合你開始的月份：*

Apr 2021

Sep 2021

Select the course time you would prefer 請選擇適合你的學習時間 *

In what language do you prefer to speak in your small group 你喜歡在小組使用的語言*

English

Cantonese

Mandarin

Choose your video language 請選擇視頻語言*

English

English with Traditional Captions

Would you be interested in facilitating? 你感興趣帶領一個小組嗎？*

Yes

No

Maybe

Gender 性別*

Female

Male

Ethnicity 族裔*

Age Range 年齡範圍*

Birthday(Year is optional e.g.02/11) 生日（月、日，如02/11，年份自願）*

Occupation or role 職業或職業角色*

What church do you attend? 你參加哪間教會？*

How did you hear about us? 你從哪裡聽到有關我們的事工？*

If you were referred, who referred you? We would like to thank them! 如果有人推薦你參加這套課程，推薦人是誰（我們會表達感謝）？

點擊“提交”後，為了完成報名程序，請填寫步驟三的表格。*

I have read the above and will complete Step 3

Please verify your request 請驗證*