Individual Enrollment Form

Personal Information:

Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone (include country code)(Required)

Gender:(Required)

Marital Status:(Required)

Church Affiliation:

Home Church

Home Church Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Please describe your involvement in church:(Required)

Ministry Reference:

Name of pastor/ministry leader:(Required)

(If you are a pastor yourself you may nominate someone in a church leadership position to provide your reference. FDMI will contact this person directly - please ensure their contact details are correct)

Position in church:

Phone (include country code)(Required)

Email(Required)

Personal Testimony:

Please describe your saving faith in Christ:

Enrollment Information:(Required)

Please indicate course you are enrolling for:

FDMI Statement of Faith:
I acknowledge that all statements on this application are true to the best of my knowledge. As a student of FDMI, I will at all times conduct myself as a Christian, faithfully and diligently apply myself to the coursework as required by the FDMI’s curriculum, and submit to the authority of the faculty and administration, all to the glory of my God and Savior, Jesus Christ.

Do you agree to FDMI statement of faith?

Yes

Individual Enrollment Form

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