GOLI Application

Complete the application form below carefully. Please make your payment before submitting your application.

Full Name *

Email Address *

Phone Number *

Programme *

Residential Address

Bank Name: Kuda MFB

Account Name: Burning Altars Revival Mission

Account Number: 3004105731

Please make payment into the account above before submitting this application.

Amount Paid *

Payment Date *

Payment Reference *

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By submitting this application, I confirm that the information provided is accurate and that my payment details are genuine.

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