2026-2027 EfM Participant Registration Form

Participant Information

Prefix

First Name (legal first name)

Preferred Name

Middle Name

Last Name

Suffix

Birthdate

Mailing Address

Country

Street

City

Region

Postal Code

Home Phone Number

Cell Phone Number

Email Address

Year Enrolling In

EfM Group ID Number

Registration Status

If you are registering for a different group, or transferring to a different group, who was your former mentor(s)?

Gender

Ethnicity

Marital Status

Diocese

What is your denominational affiliation?

Verifications and Signatures

Link to read EfM's Terms and Conditions. I have read the .pdf explaining my commitment to my EfM cohort, to EfM, and to the University of the South.

I agree to this statement.

I understand that if I withdraw:
a) before the first session, I will receive a full refund less a $75 Administrative fee.
b) within the first 30 days, I will receive a refund of $100.

Reduced fee registrations are not eligible for a refund.

I agree to this statement.

It is my understanding that this agreement, agreements ancillary to this agreement, and related documents entered into in connection with this agreement are signed when a party's signature is delivered as an electronic signature (below). These signatures must be treated in all respects as having the same force and effect as original signatures.

I agree to this statement.

Signature

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2026-2027 EfM Participant Registration Form

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