Master's International School of Divinity Seminar Registration Form

INTEGRITY ASSURANCE

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If you are a student, employee or family member of an MISD Approved Learning Partner, please select.

Title

Name

Address

City

State

Zip/Postal Code

E-mail Address

Alternative E-mail Address

Best Telephone (probably your cell phone)

Alternative Telephone

MDS Student ID#

Your Current Degree Level

CLICK HERE TO OPEN A SEPARATE WINDOW SHOWING THE CURRENT SEMINAR SCHEDULE. If you have questions or you are uncertain about anything, please call 1-800-933-1445 and ask to speak with Mrs. Jean Trotter.

I am Registering for the following Seminar to be held on the date I have indicated:

First Seminar

Date of the Seminar

Second Seminar

Date of the Seminar

Third Seminar

Date of the Seminar

Fourth Seminar

Date of the Seminar

SELECT YOUR ATTENDANCE STATUS & PAYMENT AMOUNTS

ATTEND ON-SITE FOR FULL CREDIT
At this time, I am paying a $40.00 Pre-Registration Fee for each of the Seminars I have indicated above.
The total amount of my Pre-Registration Fee(s) ($40.00 per-Seminar) is:

REGISTER FOR A DVD SEMINAR
There is no registration fee for a DVD seminar, so I am paying the full seminar amount as noted below.

SEMINAR REFUND POLICY
On-site Seminars - The seminar fee is refundable.
Online & DVD Seminars - Fees are not refundable, but may be applied to future seminars or other outstanding balances.

REGISTER FOR A LIVE ONLINE SEMINAR
At this time, I am paying a $40.00 Pre-Registration for each of the Seminars I have indicated above. The total amount of my Pre-Registration Fee(s) ($40.00 per-Seminar) is:

ATTEND ON-SITE FOR C.E.U. CREDIT ONLY
At this time, I am paying a $40.00 Pre-Registration C.E.U. Fee for each of the Seminars I have indicated above. The total amount of my Pre-Registration Fee(s) ($40.00 per-Seminar) is:

-Payment of the Actual Full Seminar Fee-
For the actual cost of any particular seminar, refer to the specific seminar information details.

In addition to paying the Pre-Registration Fee for each of the Seminars I have indicated above, I am paying the remaining Seminar Fee at this time. I also The total amount I am paying is:

-Alternative Payment the Actual Seminar Fee-

I AM NOT PAYING the rest of the Seminar Fee at this time, but I do realize I MUST PAY the final balance not later than one week prior to the Seminar (unless other arrangements have been approved.

-Complete Your Payment Method-

Total Amount I am Paying at This Time Including Pre-Registration and/or Seminar Fees:

I am paying by credit or debit card (we accept only Discover, MasterCard or Visa).

Please select the type of card to use now, and then complete the rest of the information. Or, if you prefer to give your credit card by telephone rather than online, select your preference:

Card number:

Expiration Date:

Exact Name on card:

Zip/Postal Code of the Card Holders Address (if different from above)

Alternative Payment Method: If you wish to register using a payment method other than a credit or debit card, please call 1-800-933-1445 and ask to speak with Mrs. Jean Trotter, or email her jtrotter@mdivs.edu.

Note: If you are uncertain at this point, and would rather speak to someone in person, please call 1-800-933-1445, and inform the receptionist that you need assistance.

MASTER'S International School of Divinity
PO Box 5009, 520 Kimber Lane, Evansville, Indiana 47716-5009
1-800-933-1445 | 1-812-471-0611 | fax 1-812-471-0877
General info: request@mdivs.edu Copyright © 1999 -