CityLight Leadership Institute Enrollment Form

1. First Name (Required)

2. Last Name (Required)

3. Residential Address (Required)

4. Email Address (Required)

5. Daytime Phone (Required)

6. Evening Phone

7. How did you hear about CLI?

8. What benefit do you hope to derive from CLI? (Required)

9. Are you a born-again Christian?

10. Do you go to church?

11. If yes, which church?

12. Lastly, do you make the following pledge? "I hereby present myself for enrolment at CityLight Leadership Institute. I promise to be a diligent, consistent, punctual and enthusiastic learner and to represent the school well in my conduct and interactions." Thank You!