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Course Registration Form

There is a one time CLEN Student Application fee for new students and students who 

have not attended a class for over one year.

Please download the CLEN Student Application Form and submit this form 

along with the $25 payment to the address below.

Register for Courses Online in Two Easy Steps:

(1) Complete and Submit the Registration Form

(2) Submit payment via mail or online through PayPal Donate button below.

If you have any questions, contact us at

or call (919) 412-6278.

Last Name*

First Name

Street Address



Zip Code

Home Phone Number

Cell Phone Number

Email Address

Course Registration Fee Options (Select One)

Select an option

Course Name

After successfully submitting your registration, you may submit 

payment by mailing a check/money order to:

Community Christian Center

P O Box 142

Wendell, NC 27591

or submit payment via PayPal by clicking on the

DONATE button below:

PayPal ButtonPayPal Button
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