Registration Section A - Personal Information Name : Family name/Surname : Address : Postal : Home Tel : Office Tel : Fax : Mobile : Email : NRIC/Passport Number : Country of Birth : Date of Birth : Gender : F M Are you a Thai citizen? : Yes No If not, citizen of 1st language 2nd language Marital status : Single Married Divorced Remarried Widowed How did you know about Kingdom Glory Leadership Institute? If applicable, who referred you to Kingdom Glory Leadership Institute? What are your objectives of attending Kingdom Glory Leadership Institute? Section B - Church Affiliation Name of Church : Denomination : Church Address : Years Attend : Ministry Position Held : Plan & Payment Choose Study Plan Reference Current or most recent pastor Name of pastor : Church Name : Church Tel : Church Address : Postal Code : Country : Comments or Questions Photo Upload : (file size max 1MB) Declaration I confirm that all of the information furnished above is true and complete. I agree to abide by the rules of the school if my application is accepted.