10-3-32/9/34, East Marredpally, Secunderabad – 500 026, Telangana.

Tel: +91-40-2771 6941 / 40045821

APPLICATION FORM
Choose your course

- Introduction to Biblical Counselling

- Advanced Biblical Counselling

(Fill in the application form in capital letters.)

Name: VINODKUMAR.B Male / Female:MALE

Date of Birth: 13/02/1985 Age:32

Educational Qualifications: M.Sc., MBA

Your postal mailing address:

38 / 63 EAST SAMBANDAM ROAD, R.S.PURAM, COIMBATORE, TAMILNADU, PINCODE- 641002

E-mail: vinodkumarbose@gmail.com

Telephone No: +91 7538887300

Name of your Church: BETHEL CITY CATHEDRAL

Please tell us why you want to do this course:

WANTS TO COUNSEL THE KIDS

Electronic Transfer details:

A/c No: Person to Person,
Bank : Andhra Bank, East Marredpalli Branch, Secunderabad,
Account No: 035610011017398, MICR Code: 500011026, IFSC Code: ANDB0000356

Signature: VINODKUMAR.B Date: 10.04.2018