APPLICATION FOR ADMISSION AND ENROLLMENT
P.O. Box 617 Blanchard, OK 73010
Phone: (405)485-4294 Fax: (405)485-4294
E-Mail: josharath@ pld.net
Please complete all information requested to help us prepare State, Federal, and College reports about all students. Enroll today by
including courses selected and payments as outlined on back under Financial Agreement_
Date of Application: .... _. . . Social Security # ---------.-------------- .. -- ..
Group that best describes you? Am. Indian __ Hispanic __ Asian pacific_- Black ... _ White Other . _
(or Alaskan Native) (rum-black) (Islander) (non-Hispanic)
Church Preference _." .. _ .. _ . . __ ._ _ ._ .. _ . . -._-.- -_.- - - - -- .. - .... -------.-- .. -.-.---.-.---
(Name o/Church) (Address) (City) (State) (Zip) (Denomination)
High school graduate: Yes __._._ No will graduate (Date) (OED) . Other Equivalency _
(NOTE: Official High School! Transcripts, (GED Scores, Equivalent verification, or pass an evaluation test is required for admission)
Do you qualify for Veterans Assistance'( List other tuition benefit programs you have __. . . __ . . _
Have you attended Healing Ministries Bible College & Seminary before? Yes No._. _ When?
Have you.: attended any Colleges, Technical Institutions, or Universities? Yes __ No __ this is my first time college enrollment
(NOTE: transferring credits, you are required to request colleges attended to send official transcripts directly toHMBC. No official evaluation a transcripts will be rnade from copies. No transfer of credits will be made without an official/transcript VA an Financial Aid require all official college transcripts to be an student files)
List colleges and universities attended (You can used a separate sheet of paper if necessary)
_____ . . . __ ._ .. _. __ ._._. . __._ Degree earned ... hours earned . _
__________ .. _. . __ . ._. ._.___________ Degree Earned ... __... . __ ... hours earned _
______________________ . __ . ... __ Degree Earned
__________________hours earned_. . _
_______ ~ . __ .____________ Degree Earned . . _
. One·-week mini-sessions are arranged several times during the year to enable distance learning student. to have the experience of sitting under HMBC professors and being classified as a campus student.
PROGRAM OF STUDY
Degree Plan? __ Associate of Arts (AA) in Theology _ in Bible (63 Semester hours)
Bachelor of Arts (BA) in Biblical Studies __ (123 Semester hours)
-._- Master of Arts (M/\) in Ministry _ (36 Semester hours)
-- Master of Divinity (M. DIV.) -90 Semester hours)
Please select the initial course/s in the, order you would like to begin your studies. Do not select courses previously taken at ~another college or Seminary with a grade of C or better. Please list course prefix, number and title. Transfer students must have official transcripts on file prior to finalizing their degree program.
First Choice __________________________ Second Choice______________________________ Third Choice____________________________
___ Check Here If Applying Federal Financial Aid (not available to HMBC at this time)
Select METHOD OF;' PAYMENT
1. Pay application fee, book cost, and total tuition (four classes)and receive a 05% tuition discount.
2.Pay application fee, plus book; cost")plus 1/3 tuition, and balance in 3
and balance in 3 equal monthly payment of $ _
Note: A credit check may be required if payment plan is selected.
D Credit Card:~ Visa Master Card __ Discover _Am Exp Debit Credit C.ard #~ ~_. Expiration date______
on credit card Charge my credit card $ _. _each month on this date:. _
Debit Card __ Visa ------MasterCard __ '__ Discover __ . Am Exp Debit Card # .... . _
Expiration date on debit ________________
Name on account ______________________________________________________________Name of Bank________________________________________
Checking account # __________________________________Checking account Routing_______________________________ _____________
Charge my debit ,card .. $ . __ ... __ .. __ each month on this date: _ .. .". ._ .. _
Amount submitted with this application $ . . _
TUITION and FEES Application Fee ~~ $50.00 for all programs Shipping Fee $ 10 (home study only)
One Time Application Fee $50.00
Re-Enrollment $10. REFUND POLICY
Undergraduate AA $235. Per credit hour 1st week 100%
Undergraduate BA $285. Per credit hour 3rd week 60%
Graduate Master $335. Per credit hour
Graduate Master of Divinity $385.00 Per credit hour
Resource Fee $ 4. Per hour (campus only) 5th week 20<}-o
Book costs vary per course, you may call (: an admissions counselor or our business office for exact cost of' books. One Percent (1.0%) IS charged monthly on the unpaid balance. $20.~ penalty is added monthly to accounts failing to make monthly payments as agreed. Foreign students must prepay shipping and handling charges.
APPLICATION ENROLLMENT and AGREEMENT
NOTE: Transmission of this agreernent by e--mail or fax with written or signed name and initial payment is acceptable as a firm commitment in good faith by all parties.
I certify that I have read and agree with the terms of this Application
Applicant’s Signature Date
(Parent or legal Guardian ( if applicant is under 21 years of age
;________________________________________________________________________________________ Parent or Guardian signature Date
HEALING MINISTRIES COLLEGE & SEMINARY OFFICE USE ONLY
Application Fee Paid _________________________Application Date __________________________________Approved By_______________________
. .NOTE!: Healing Ministries Bible College & Seminary selects its students and administers all