COURSE ENROLMENT FORM Please complete the below form in full in order to enrol for one of the courses we offer. Payment to only be submitted once you have been approved for a course. Your Full Name (required) Preferred Name (if applicable) Your Email (required) Cell Number (required) Your Address (required) Affiliated Correllian Temple/Shrine? (required) Status within the Correllian Tradition (required) High PriesthoodClergyOuter CourtDedicantNot a member Course Options: ---Correllian First DegreeCorrellian Second DegreeCorrellian Third DegreeLiving the Wiccan LifeCorrellian MinistryCorrellian PhilosophyFive Mystic SecretsSpells for Second DegreeRitual in Theory & Practice Why are you enrolling for this course? Are you willing to complete all the Course Requirements? YesNo Are you in a position to make your home available for lesson meet-ups? YesNo Do you have any learning disabilities? YesNo Payment Option: (Excludes short courses) ---1 x Full Installment2 x Installments3 x Installments6 x Installments Payment Method: ---CashEFT