MESOM Registration

Student's Name *

First

Last

Email Address *

Would you like to receive email updates from the Maine School of Ministry? *

This is in addition to any official communications regarding your enrollment or your course(s).

Primary Phone Number *

Is this a cell phone number? *

Would you like to receive occasional text updates from the Maine School of Ministry? *

Mailing Address *

Address Line 1

Address Line 2

City

State

Zip Code

Have you attended a MESOM Course with us previously? *

How did you hear about the Maine School of Ministry? *

Other - How did you hear about the Maine School of Ministry? *

Briefly describe how/where you heard about the Maine School of Ministry

Which of the following best descibes you? *

Other - Which of the following best describes you? *

Briefly describe your classification (e.g. your title, role, profession, etc.)

2024 June Intensive Tuition *

Partial scholarships are available for Maine students if requested and approved. Would you like to apply for a scholarship? *

To apply for a scholarship in a specific amount, please email Dean Malcolm Himschoot: mhimschoot@maineucc.org by May 23rd.

Method of Payment *

Select your method of payment, all outstanding payments are due prior to the first course meeting.

Credit Card *

Card Number

Security Code

Name on Card

Expiration/

Total

$ 0.00

Registration for the Maine School of Ministry