Online Form: MIP Student Profile

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If you completed the Ministerial Internship Program (MIP) and want to receive CIMS credit, please answer the following:*

I want to apply my MIP studies toward CIMS credits.

I want to apply both my CAMS and MIP studies toward CIMS credits.

Please select from the list the state/region completed MIP.*

Enter the year completed MIP.*

If you are unsure, please select your best guess.

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Name*

First Middle Last Suffix

Today's Date

Name used when enrolled in MIP*

First Middle Last Suffix

Email*

Phone*

Birth Date*