2024-2025 Surge School Registration

Participant Contact Information

Name

This address will receive a confirmation email

Phone

Address

Registation Information

Church

Leaders Name

Registration Code for leader

Registration Type

Individual Married Couple Ordering for a group (Bulk)

Spouse Name (If attending with Spouse)

Vocation Questionnaire

We hope to cultivate deeper connection within our Surge community, especially related to your work and engagement in the city. We'd love it if you would answer the following questions so we can continue to foster these connections!

What type of role best describes you position?

How long have you worked at your current workplace?

Do you currently gather with other Christians in your workplace? Yes No

Surge School Payment

Please note: As a Surge School member, you can choose either the web version or the printed version of the readers. Costs are outlined below

Individual Orders (If ordering in bulk, select the last option in the dropdown)

Payment (Choose your Surge Reader Version)

Bulk Order

Bulk Printed Reader (Individual): Enter total based on $99 per copy

Bulk Printed Reader (Couple): Enter total based on $150 per set.

Bulk Web Reader Only (Individual): Enter total based on $60 per access.

Bulk Web Reader Only (Couple): Enter total based on $100 per access.

Bulk Ordering (Enter Total Cost Amount)

Notes (If ordering in bulk specify how many readers you need and in what format [printed/digital])

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

2024-2025 Surge School Registration

Description

Please Fix the Following