| DMin Registration May 2008 |
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| Last Name * | |
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| First Name * | |
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| Middle Name | |
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| Preferred name for name tag if different from first name | |
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| Student ID Number if known; disregard if not known | |
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| Preferred Mailing Address: Street * | |
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| Preferred Mailing Address: City, State, and Zip Code * | |
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| Is this address: * | |
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| Home Phone Number * | |
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| Work Phone Number | |
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| Email Address * | |
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| DMin Track * | |
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| Emergency Contact Person: Name * |
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| Relationship to you * | |
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| Emergency Contact Phone Number and type (home, cell, work?) * | |
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| Continuing Enrollment |
| Select if not taking any classes in May 2008 |
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| May 13-16, 2008 - Select one course if applicable |
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| May 19-23, 2008 - Select one course if applicable |
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| June 16-20, 2008 - Campus Ministries week one | |
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| June 23-27, 2008 - Campus Ministries week two | |
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| Independent Study for May 2008 |
Check box #1 to register for an Independent Study.
Submit an Independent Study form to the DMin Office for each study.
Obtain agreement from the professor with whom you wish to do this course.
The form is available at www.wesleyseminary.edu/dmin, scroll down to D.Min. Forms |
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| * Required |
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