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Step 3: Pre-Enrollment Checklist for CIMSMedia2021-10-19T10:03:43-05:00

Online Form: Pre-Enrollment Checklist

Registration Date*
Month
Day
Year
Name*
First Middle Last
If you do not have a middle name, place an 'x' in the Middle Name field.
Social Security Number*
Ministerial Number
Phone Number*
Email*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
I will be studying through:*
- Internet
- DVD
- Distance Learning Center (DLC)
- Distance Learning Seminar (DLS)
Distance Learning Center (DLC) or Distance Learning Seminar (DLS) location*
Please indicate yes or no that you:
Toured the educational facility?*
- Yes
- No
Received an institutional catalog.*
- Yes
- No
Was given the time and opportunity to review the institutional policies in the catalog.*
- Yes
- No
Has been informed of the length of the program for full-time and part-time students in the academic terms and actual calendar time.*
- Yes
- No
Has been informed of the total tuition and other fees of the program.*
- Yes
- No
Has been informed of the estimated cost of books and any required equipment purchases such as a stenography machine, computer, specialized tools, art supplies, etc.*
- Yes
- No
Has been given a copy of the institutional refund policy.*
- Yes
- No
Has been given the address and telephone number of Commission Staff (Tennessee Higher Education Commission, 404 James Robertson Parkway, Nashville, TN 37243-0830, (615) 741-5293) along with a statement that reads: “Any person claiming damage or loss as a result of any act or practice by the Church of God School of Ministry that may be a violation of the Title 49, Chapter 7, Part 20 or Rule Chapter 1520-01-02 may file a complaint with the Tennessee Higher Education Commission, Division of Postsecondary State Authorization”; after exhausting the grievance process at the institution.*
- Yes
- No
Has executed (signed) a Transfer of Credit Disclosure Statement in compliance with T.C.A. § 49-7-144 and understands the specific limitations should the institution have articulation agreements.*
- Yes
- No
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).*
- Yes
- No
Visit http://state.tn.us/thec
If applicable has received and understands the institution’s cash discount policy.*
- Yes
- No
Additionally, I affirm that the document clearly indicates that it is the Preenrollment Checklist, is paginated pursuant to Rule 1540-01-02-.13(1), and includes the full and correct name and address of the authorized location of the institution. I understand that if DSPA determines in the future that the Preenrollment Checklist is not compliant as described herein, my institution will be subject to adverse action pursuant to Rule 1540-01-02-.22.*
- Yes
- No
Hidden
Signature
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.*
Date*
MM slash DD slash YYYY

The Division of Education has oversight of programs, expansion, and development of colleges, seminaries, universities, Bible institutes, and ministerial training models throughout the International Church.

P.O. Box 2430
Cleveland, TN 37320-2430
support@cogdoe.org
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