Financial Peace University @ Wellspring United Methodist Church
Wednesdays - Sep 10th - Nov 5th | Please fill out this form and click submit register.
PLEASE NOTE:
This registration is considered per household. The household will receive one book and login.
Thank you.
Main Individual Information (details used to complete your registration in the class)
Name
*
Email
*
This address will receive a confirmation email
Phone
*
Phone Type
*
Please select one option.
Mobile
Home
Select Option
Mobile
Home
Address
*
--
AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
Are you a member of Wellspring?
*
Please select one option.
Yes
No
Select Option
Yes
No
If you are not a member, how did you hear about us?
Additional Individual
Name (First, Last)
Email
This address will receive a confirmation email
Phone
Phone Type
Please select one option.
Mobile
Home
Select Option
Mobile
Home
Are you a member of Wellspring?
Please select one option.
Yes
No
Select Option
Yes
No
If you are not a member, how did you hear about us?
Payment Information
Payment
$79
Credit/Debit Card Number
Expiration Date/CVC
Name on Card
Card Billing Address
AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
Submit
Description
Wednesdays - Sep 10th - Nov 5th
Please fill out this form and click submit register.
×
Please Fix the Following