Kentucky School of Ministry Class Registration Form

* See Reverse Side *

January 18-19, 2013 @ Camp Crestwood Cost = $55 registration fee + the price of the textbook(s) and an additional $5 for breakfast if desired.
The registration fee includes overnight lodging @ Camp Crestwood. Textbooks are available through the District Office.

REGISTRATION BEGINS AT 5:30PM ON FRIDAY IN THE CAFETERIA Chapel and Student Orientation begins @ 7:00 PM.

Classes offered this Month

Certified or Diploma in Biblical Studies: Life of Christ Teacher: TBA Textbooks: The Life of Christ By: Ralph Riggs AND A Harmony of the Four Gospels By: Orville Daniel (Second edition) The Harmony book is Mandatory Required reading textbook Price thru KSOM: $16 (Riggs bk) + $18 (Daniel bk) + $5 shipping fee (if needed) Licensed: Introduction to Systematic Theology Textbooks: Systematic Theology By: Stanley M. Horton Price thru KSOM: $30 + $5 shipping fee (if needed) Ordained or Continuing Education: Apologetics Textbooks: A Ready Defense By: Josh McDowell Price thru KSOM: $16 + $5 shipping fee (if needed) Teacher: TBA

Teacher: TBA

All textbooks are available for purchase through our website at www.kyag.org/enrollment-registration, then click on Order Textbooks Here

The deadline for registration for this class is January 4, 2013.

The registration form and fee must be received in the District Office no later than this date. Withdrawals or transfers of fees to a later class must be requested no later than 10 days prior to the class session, except in the case of an unforeseen emergency (accident, illness, funeral, etc.). Note there is a Return Check fee of $25 for all returned checks. The Study Guide will be mailed upon registration. Study guides must be handed in upon arriving at the Friday night teaching session. Students must have two copies of their Study Guide PRIOR to arriving. One will be turned in; the other copy is for further study.

Make checks payable to: Kentucky Ministry Network. Send payment to Kentucky District at PO Box 98, Crestwood, KY 40014

Registration Information January 18-19, 2013

Name: Address: City: Email: Church: ___________________________________ ___________________________________ ____________________ State: _____ Zip: __________ ____________________ Phone: ___________________ ____________________ Pastor: ___________________
(Indicate below which class you are registering for) _____ Continuing Education _____ Diploma in Biblical Studies

Class Registration Fee:

_____ Certified _____ Licensed _____ Ordained

$55.00

Breakfast Registration Fee:

$ 5.00

Students who eat breakfast in the cafeteria at Camp Crestwood must pay this fee. This fee must be paid in advance with registration so we will know how much food to purchase and prepare. Please indicate that you are eating breakfast at Crestwood by checking this blank _____.

Total Registration Fee:

($60 with breakfast - $55 without breakfast)

$_____

Textbook(s) & Shipping: Book(s) $_____ + Shipping ($5) - total books/shipping = $_____
* See the book charge on the reverse side of this form for the price of the textbook(s). * The $5 shipping fee is required anytime we mail the book and/or Study Guide to a student. * The $5 shipping fee is not required if a student picks up their books & study guide at Crestwood. * Please indicate if you want your study guide in hard copy form ___ or e-mailed copy ___.

Internship: (This is a reminder only. You cannot register for the internships on this form.)
* Students who are pursuing ministry credentials must complete the required Ministry Internship for each level of ministry credential for which they will be studying and/or applying. * A student should register for their internship upon completing one class. * See any member of the KSOM staff, or call the District Office (502-241-7111) or email ksom@kyag.org to obtain an internship registration form and learn more about internships.

Lodging @ Hilton Garden Inn. $101.00

* KSOM has arranged for a discount rate at the Hilton Garden Inn. * Students who wish to reserve a room at the Hilton Garden Inn at this rate must pay the room fee through KSOM in advance with this registration form. * This discount fee does not include breakfast at the hotel. * Students who eat breakfast at the hotel will need to pay for that meal individually/separately. * Hotel meals and room service cannot be billed to rooms booked through KSOM.

$_____

Total costs for this registration: (add the sum of the above that apply) $_____ NOTE: Return Check fee of $25 for all returned checks
******************************************************************************* For office use only Registration received _____ Fee Received _____ Book Paid For _____ Study Guide Sent _____ Breakfast ___________ Shipping __________ Check #: _________