iDi: Registration

REGISTRATION FORM
Spring 2008

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 ($120/credit) Audit ($80/credit)

Classes:

	Daniel & the Critic's Den [3 credits]
	Theology III [3 credits]
	The Unfinished Task: An Intro to Missions [3 credits]

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.