Registration Form

D.Min. Information Seminar Registration

Wednesday, June 26, 9:00 am-12:00 noon

Please reserve your place by June 24, 2013.

First name

Last name

Street

Street (line 2)

City

State

Postal code

Preferred contact number

Denomination

Ministry position

When are you interested in starting the Doctor of Ministry Program?

January 2014June 2014January 2015
Other

Theological Degree

M.Div.
Other

Other degree

Date degree received

Preferred method of contact

Please list any dietary restrictions.