Campus Visit Form  

 
Please indicate what type of visit you're interested in
       
 
 
 
 
 
Contact Information
 
* Title:
* Full Name:
* Email:
* Phone #      Ext.
* Address:
* City:
* Prov./State:
* Post/Zip Code:
Country:
 
Personal information
 
Birth Date: / /
* What program(s) are you
interested in at Prairie?
 
 
* How many others will
be accompanying you?
Name and Relation:
 
Questions/Comments
 
 
   




   
 

Prairie Bible Institute
Box 4000
Three Hills, AB T0M 2N0
1-800-661-2425

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