IRELAND Registration FormMarried For Life Please enable JavaScript in your browser to complete this form.InformationHusband's Name *FirstLastWife's Name *FirstLastAddress *Address Line 1Address Line 2CityState / Province / RegionPostal CodeCountry *IrelandPhone *Email *Husband's Age Range *18-2526-3940-5960+Wife's Age Range *18-2526-3940-5960+Have you been married before? (Husband) *YesNoHave you been married before? (Wife) *YesNoHow many children do you have? What is their age range?Your Church name and address, Your Pastor's name *Preferred Time (tick all that apply) *Monday eveningThursday eveningSaturday eveningTuesday eveningFriday eveningSunday daytimeWednesday eveningSaturday daytimeSunday eveningHow you want to attend the course? *In PersonOnlineEitherHow you want to receive your manual? *Paper (+€15)Online - ElectronicCourse Language *Choose a languageEnglishPortugueseLeaders - English *Choose a leadership coupleAlex and Gislaine SilvaAlex and Polyana GanecoDouglas and Keyla TeixeiraFelipe and Tatiana Silva / MonzonRay and Cheila FernandesLeaders - Portuguese *Choose a leadership coupleAlex and Gislaine SilvaAlex and Polyana GanecoDiego and Camila RibeiroDouglas and Keyla TeixeiraFelipe and Tatiane MonzonGustavo and Ana CunhaYour Personal Details (please choose) *Yes - 2=1 may keep these contact details so we can be contacted by email (or other methods) with updates and invites to future courses/conferences and other events. Any prayer points and our attendance record will also be kept for the duration of the course only. We understand that 2=1 will not share our details with anyone else.No - 2=1 may not keep these contact details after our potential course is finished.How did you find out about this course?CommentsPaymentCOURSE Prices (per couple) Standard Price Concession Price* €50 online €30 online €65 paper manual €45 paper manual Payment *Choose an optionSTANDARD PRICE - Online manualSTANDARD PRICE - Paper manualCONCESSION PRICE - Online manualCONCESSION PRICE - Paper manual*Concessions include: Those who are in full time Christian work Those who are full time students Those who are retired Those who are on benefits Those who have already taken any one of our courses. AgreementBy clicking REGISTER we understand that you will pay the fees as shown in the next page. If we desire to cancel your registration, we must request a refund in writing no later that one (1) week prior to the start of our assigned group. MessageRegister
