Building Blocks Registration - Support Staff
Contact Information
Do you know your CSL ID Number?
Your CSL ID number will begin with the letter "I-" (as in identification) (
ex: I-12345
)
Yes
No
CSL ID Number
Please select your ID number from the dropdown menu.
Your CSL ID number will begin with the letter "I-" (as in identification) (
ex: I-12345
). If you are unsure what your ID number is, please contact
bmartin-swann@csl.org
.
You
MUST
select the ID number from the dropdown menu in order for your information to populate.
Name:
Email Address:
If your email address needs to be updated, please email
bmartin-swann@csl.org
.
Contact Information
Please enter the information below.
First Name:
Last Name:
Email Address:
Phone Number:
Street Address:
City:
State:
Please do not abbreviate
Zip/Postal Code:
Country:
Email:
Course Information
Please select your course from the dropdown menu.
You
MUST
select the course from the dropdown menu in order for the form to process.
Cost:
$
USD
Start Date:
Course Name:
Zoom Link:
Meeting ID:
Passcode:
Notes:
Add another course?
Yes
No
Course 2 Information
Please select your course from the dropdown menu.
You
MUST
select the course from the dropdown menu in order for the form to process.
Start Date:
Cost:
$
USD
Course Name:
Zoom Link:
Meeting ID:
Passcode:
Notes:
Add another course?
Yes
No
Course 3 Information
Please select your course from the dropdown menu.
You
MUST
select the course from the dropdown menu in order for the form to process.
Cost:
$
USD
Start Date:
Course Name:
Zoom Link:
Meeting ID:
Passcode:
Notes:
Please select the Minister you are accompanying to the course(s) listed above:
Start typing to narrow results.
Payment Information
Total Amount Due:
$
USD
Cardholder First Name:
Cardholder Last Name:
Credit Card Type:
Please select...
Visa
Mastercard
Discover
American Express
Credit Card Number:
CVV:
Expiration Month:
Please select...
01
02
03
04
05
06
07
08
09
10
11
12
Expiration Year:
Please select...
2021
2022
2023
2024
2025
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
By clicking submit below you are agreeing to pay the tuition as described for enrollment in the above listed course(s).
PLEASE NOTE: If you receive an error message on this form, STOP and do not resubmit the form. Contact
bmartin-swann@csl.org
before continuing.
Do NOT resubmit the form.
Authnet_Hidden_Fields
Contact Information