Step 5: Enrollment Agreement

CERTIFICATE IN MINISTERIAL STUDIES (CIMS)
ENROLLMENT AGREEMENT

The Church of God School of Ministry is authorized by the Tennessee Higher Education Commission. This authorization must be renewed each year and is based on an evaluation of minimum standards concerning quality of education, ethical business practices, and fiscal responsibility.

Enrollment Information

Date of Application*

Date Training Begins*

Program Length:
36 Months

Status of Student*

Full-Time
Part-Time

Projected date of completion*

Enter the date three (3) years from the date of application.

Name*

First Middle Last

If you do not have a middle name, place an 'x' in the Middle Name field.

Maiden Name

If applicable.

Social Security Number*

Ministerial Number

Only applicable if you are a credentialed Church of God minister.

Date of Birth*

Phone*

Email*

Gender*

Female
Male

Married Status*

Ethnicity*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Background

Please enter the dates you received the following, if applicable:

High School Diploma - Year

GED Equivalency - Year

College Graduate - Year

Graduate School - Year

Other

Employer

Employer's Phone Number

Employer's Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

CIMS Enrollment

I will be studying through:*

Internet
DVD
Distance Learning Center (DLC)
Distance Learning Seminar (DLS)
Lilly Grant Recipients

DLC or DLS Location

Date I plan to begin my first CIMS course:*

Grievance Policy

Any grievances not resolved on the institutional level may be forwarded to the
Tennessee Higher Education Commission, Nashville, TN 37243-0830, (615-741-5293).

CIMS Courses

Instructions: After reviewing the entire page, check the courses you plan to complete. A copy of this completed form will be sent to the email provided above.

CIMS Course Costs

Hidden

Select the courses you plan to complete.

Hidden

Signature

Has received the most recent withdrawal, completion, and placement data as calculated by the Commission in one of the ways described in Rule 1540-01-02-.13(1)(j). For the program titled Certificate in Ministerial Studies (CIMS), I have been informed that for the period of July 2019–June 2020, the withdrawal rate is .183%, the completion rate is .004%, and the in-field placement rate is .004%. Detailed statistical data for this program may be viewed by going to http://state.tn.us/thec and clicking on the “Authorized Institution’s Data” button.

I, the student, have read and understand this document.*

Yes
No

Enter your name in the field below, and it will count as your signature.*