Registration for the Maine School of Ministry Use the form below to register for the 2023 Fall Semester with the Maine School of Ministry (MESOM). Please enable JavaScript in your browser to complete this form.Student InformationStudent's Name *FirstLastEmail Address *Would you like to receive email updates from the Maine School of Ministry? *YesNoThis is in addition to any official communications regarding your enrollment or your course(s).Primary Phone Number *Is this a cell phone number? *YesNoWould you like to receive occasional text updates from the Maine School of Ministry? *YesNoMailing Address *Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeHave you taken or audited a course with us previously? *YesNoHow did you hear about the Maine School of Ministry? *My PastorA Member of My ChurchMESOM SundayA MESOM Staff MemberSocial Media (Facebook, Instagram, etc.)OtherOther - How did you hear about the Maine School of Ministry? *Briefly describe how/where you heard about the Maine School of MinistryWhich of the following best descibes you? *ClergyMember In Discernment (MID)Lay LeaderCongregant (Church Member)Maine Conference UCC StaffNational UCC Staff or other UCC Conference StaffOtherOther - Which of the following best describes you? *Briefly describe your classification (e.g. your title, role, profession, etc.)Course SelectionWhat course(s) are you interested in taking this semester? *Intro to New Testament (1) - Gospels and ActsPastoral Care in an Embodied FaithCourse Options (Intro to New Testament (1) - Gospels and Acts) *Full Course (Credit Student) - $ 350.00Registration deadline: Aug. 28, 2023 Course Options (Pastoral Care in an Embodied Faith) *Full Course (Credit Student) - $ 350.00 Registration deadline: Aug. 12, 2023Payment OptionsScholarships are available for those with demonstrated need. Would you like to apply for a scholarship? *YesNoRequest for scholarship must be received by registration deadline. For Intro to New Testament I, registration deadline is Aug. 28, 2023. For Pastoral Care in an Embodied Faith, registration deadline is Aug. 12, 2023. Email mhimschoot@img.2b3.myftpupload.com to request a form.Method of Payment *Credit/Debit CardCheck (Mail-In)Select your method of payment, all outstanding payments are due prior to the first course meeting. Credit Card *Card NumberSecurity CodeName on CardExpirationMM123456789101112/YY2324252627282930313233Total$ 0.00EmailSubmit