Deep Bible Training Center

DEEP

DEEP BIBLE TRAINING CENTER

Student Class 2014Registration

All information below must be completed accompanied by applicable payment when application is turned in.

Date____/____/____Driver’s License Number:

Name

Last NameFirst NameMiddle Name

Date of Birth ______/______/______Place of Birth ______SSN ______- ______- ______

Mailing Address

Street/Box City State Zip Code

Email

Home phone ( )______Mobile ( )______Fax ( )______

List of schools or colleges you have attended (Please include the name and mailing address of the last school attended) ______

______

What is your highest level of diploma or degree ______

Please select payment options below:

Initial Enrollment: (5.1.14 – 8.31.14)

Tuition and Textbooks (Includes manual)$350.00

Initial Enrollment w/$50.00 Late Fee (after 8.31.14)

Tuition and Textbooks (Includes manual)$400.00______

*General Audit (DEEP Graduates ONLY)

Without Textbooks & Manual & Certificate$100.00______

Year Graduated ______

No payment plan

*Certified Audit (DEEP Graduates ONLY)

Without Textbooks & Manual$100.00______

Year Graduated ______

No payment plan

*Bible Study Audit

Without Textbooks & Manuals$200.00______

No payment plan

* General Auditors/Bible Study Auditors will just attend DEEP as if it was a bible study (no test, essays, books or handouts) and will be required to check-in. Certified Auditors will be required to take tests, turn in essays and will be tracked on attendance.

Payment Schedule:Payment schedules are provided only for Initial Enrollment and Initial Enrollment w/ Late Fee. Auditors pay full price at registration.College Weekend discounts are only good if amount is paid in full at time of registration on the date indicated.

Payment Option 1: 100% at registration $350 on or before 8.31.14 or $400 after 8.31.14 $______

Payment Option 2: 50% at registration or $175 on or before 8.31.14 or $200 after 8.31.14 $______

50% on or before 11.2.14 ($175 or $200) $______

(If final payment is not made by due date, you will be dropped from the class.)

Payment Method and Signature:

Payments must be made by using cash, check or credit card. Initial payment and all other payments are due at The Filling Station Bookstore.

Please select one:

Cash *Check #Credit Card ___

Card #---______

Expiration Date: // Amount: $______3 digit code ______

Card Holder’s Name: __ ___

Card Holder’s Signature: ___

*A fee of $20.00 will be charged for any returned checks.

Childcare:

Will you be using child care services? Yes No

If yes, please list children’s information:

Name:Age:School Class Grade:

1.

2.

3.

4.

I understand that the DEEP Bible Training Center, Hobbs, NM is primarily a religious school. Credits are not guaranteed to be accepted by secular or state run programs. This school is not affiliated with the Department of Higher Education of New Mexico. DEEPis accredited by Accrediting Commission International. ACI is primarily a private school association unrelated to government accreditation.Please refer to the handbook for any other questions.

Signature:

Print name:

Hoodie Size ______

Approved:

Shirt Size ______Charity Kalstrup, Administrator

(over)CLC 4/12