Application – Midwestern School of Divinity

I am a communicant of the following Province *

First Name *

Middle Name/Initial

Last Name

Street Address *

City *

State/Province *

ZIP / Postal Code *

Country

Phone *

Email Address *

Date of Birth *

I am *MaleFemale

Marital Status *

Educational BackgroundPlease enter the name, address, phone number and certificate, diploma or degree earned from each school you attended. DO NOT include any Honorary Degrees and/or titles received.

I am applying for admittance into *Licentiate in Sacred TheologyMaster of DivinityMaster of Sacred TheologyDoctorate of Sacred TheologyPlease indicate the program you desire to enroll in.

Credit / Debit Card *

There is a one time, non-refundable application fee in the amount of $25 USD

I certify that all information presented and contained in this application is true and accurate. *Yes

Singed *