iDi: Registration

REGISTRATION FORM
Spring 2013

Last Name:

First Name: Inital:

Address:

City: Zip:

E-mail (primary):

E-mail (secondary):

Home Phone: Cell Phone:

Church Affiliation:

Are you a new student? Yes No

Type of Enrollment: For Credit Audit

Classes:

	Book of Daniel [3 Credits; Credit: $99, Audit: $99]
	New Testament Survey [3 Credits; Credit: $59, Audit: $59]

Total Number of Credits:

Tuition:

Please send me information about the deferred payment option.

Comments:

iDi does not discriminate on the basis of ethnic or national origin in its admissions policy.