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   Cost:       $120 plus books
   Time:        Mondays, 7-10pm
   Location:  Church of the Nazarene
                     4277 Quadra St. 
                     Victoria, BC

   Please provide the following contact information:

First Name
Last Name
Street Address
Address (cont.)
City
Province
Postal Code
Home Phone
FAX
E-mail
Which course are you applying to take?

What is your educational background?

What is your current church affiliation?