AZUSA World Ministries Training Institute

Non-Degree Student Enrollment Package

Application
Program

of Choice / Fee Schedule

Education

Information

Statement
Automatic

of Faith

Credit Card Billing Authorization Form

Please be sure to fill out the entire packet in and send back

Mail / Return your application to:

5109 W. Thomas Rd. Phoenix, AZ. 85031 Office Number: 602-269-6959 / Fax 602-269-7933

New Student

Returning Student

Program Option: On-Campus

AZUSA Member

CD

DVD

Non-Member

On-Line

Confidential Information:
Gender: Male Female

Salutation: Mr. Mrs. Miss. Ms.

Jr. Sr. I II. III.

Name: _________________________________________________________________________________________
(First)
(Middle)
(Last)
Degree Student Only: Social Security Number _________/_________/_____________
Citizen of: __________________________________________________ Date of Birth _______/_______/_________
Mailing Address: ________________________________________________________________________________
(City)

Telephone: (

) ______________________ (

(State)

) ______________________ (

(Home)

(Work)

(Zip)

) ______________________
(Cell)

Email address: ___________________________________________________________________________________

Emergency Contact Name: __________________________________Telephone: (

Marital Status: Married

Single

Separated

Divorced

) ______________________

Widow

If applicable Name of Spouse:______________________________________________________________________

(First)
(Middle)
(Last)

Is English your Primary Language: Yes

No

Please list the Names and relationship of any students who have attended or are attending MTI.
1. ____________________________________________________ Relationship: _____________________________
2. ____________________________________________________ Relationship: _____________________________
3. ____________________________________________________ Relationship: _____________________________

Mail / Return your application to:

5109 W. Thomas Rd. Phoenix, AZ. 85031 Office Number: 602-269-6959 / Fax 602-269-7933

Briefly explain why you want to attend MTI: _________________________________________________________

________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________

What do you feel is your call? Apostle Prophet Teacher Evangelist Pastor Ministry of Helps

List the Church you currently attend: _______________________________________________________________

How did you hear about MTI? MTI Testimony

Radio

TV

Newspaper

another Student

Visit to Azusa

Word of mouth

Church member

other: ___________________

MINISTRY TRAINING INSTITUTE is supported by free will offerings and Committed Partners.

Yes, I will be a financial and prayer partner with Dr.s Alfred & Beverly Craig, and in support of their
vision of MTI to Train Ministers and those called to Ministry of Helps to establish churches throughout Arizona,
the United States and the World.

I will become a: Gold Partner (2year commitment)

My Monthly commitment is: $5.00

$10.00

Platinum Partner (4 year commitment)

$20.00

$50.00

Other ______________________

Signature___________________________________________________ Date ________/_________/_____________

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Mail / Return your application to:

5109 W. Thomas Rd. Phoenix, AZ. 85031 Office Number: 602-269-6959 / Fax 602-269-7933

AZUSA Members Non-Degree Fee Schedule

*** Books & Notes Not Included

Option # 1 Certificate In Advanced Biblical Studies (Two Year Program)

(On Campus) $50.00 Registration Tuition Free
Correspondence (CD or DVD) $75.00 Registration $156.25 x 24 monthly payments = ($3,750.00)
(Online) $95.00 Registration $156.25 per Class = (32 Classes)

Option # 2 Diploma in Practical Ministry (Four Year Program)

(On Campus) $50.00 Registration Tuition Free
Correspondence (CD or DVD) $75.00 Registration $156.25 x 48 monthly payments = ($7,500.00)
(Online) $95.00 Registration $156.25 per Class = (64 Classes)

Option # 3 Diploma in Church Organization and Management (Six Year Program)

(On Campus) $50.00 Registration Tuition Free
Correspondence (CD or DVD) $75.00 Registration $156.25 x 72 monthly payments = ($11,250.00)
(Online) $95.00 Registration $156.25 per Class = 96 Classes

NonMembers Non-Degree Fee Schedule

*** Books & Notes Not Included

Option # 1 Certificate In Advanced Biblical Studies (Two Year Program)

(On Campus) $50.00 Registration $104.16 x 24 monthly payments = ($2,500.00)
Correspondence (CD or DVD) $75.00 Registration $208.13 x 24 monthly payments = ($5,000.00)
(Online) $95.00 Registration $156.25 per Class = (32 Classes)

Option # 2 Diploma in Practical Ministry (Four Year Program)

(On Campus) $50.00 Registration $104.16 x 48 monthly payments = ($5,000.00)
Correspondence (CD or DVD) $75.00 Registration $208.33 x 48 monthly payments = ($10,00.00)
(Online) $95.00 Registration $156.25 per Class = (64 Classes)

Option # 3 Diploma in Church Organization and Management (Six Year Program)

(On Campus) $50.00 Registration $104.16 x 72 monthly payments = ($7,500.00)
Correspondence (CD or DVD) $75.00 Registration $208.33 x 72 monthly payments = ($15,000.00)
(Online) $95.00 Registration $156.25 per Class = 96 Classes
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Mail / Return your application to:

5109 W. Thomas Rd. Phoenix, AZ. 85031 Office Number: 602-269-6959 / Fax 602-269-7933

Education Information
Please include both Traditional Four Years and Non Traditional school attendance,
including Bible Training and Seminaries.

#1 Institution name: ______________________________________________________________________________

Institution City and State: _________________________________________________________________________
Major ____________________________________________________ Hours attended________________________
Transcript (select one): Attached
Diploma/Certification/Degree: Yes

To follow
No

Not Available

Date of completion: _________/___________/____________

#2 Institution name: ______________________________________________________________________________

Institution City and State: _________________________________________________________________________
Major ____________________________________________________ Hours attended________________________
Transcript (select one): Attached
Diploma/Certification/Degree: Yes

To follow
No

Not Available

Date of completion: _________/___________/____________

#3 Institution name: ______________________________________________________________________________

Institution City and State: _________________________________________________________________________
Major ____________________________________________________ Hours attended________________________
Transcript (select one): Attached
Diploma/Certification/Degree: Yes

To follow
No

Not Available

Date of completion: _________/___________/____________

Mail / Return your application to:

5109 W. Thomas Rd. Phoenix, AZ. 85031 Office Number: 602-269-6959 / Fax 602-269-7933

Pastoral and Ministerial Experience

Please complete this section; a brief description of your ministerial duties would be greatly appreciated. This
information may be considered for transfer credit for the lifetime learning program. Please include additional
information on your resume.

CURRENT MINISTRY INVOLVEMENT

Name of church: ___________________________________________ Pastor/Overseer_______________________
Ministerial position _____________________________________ Begin/end dates (month/year) _______________
Type of Ministry duties___________________________________________________________________________
MINISTRY EXPERIENCE
Name of church: ___________________________________________ Pastor/Overseer_______________________
Ministerial position _____________________________________ Begin/end dates (month/year) _______________
Type of Ministry duties ___________________________________________________________________________
MINISTRY EXPERIENCE
Name of church: ___________________________________________ Pastor/Overseer_______________________
Ministerial position _____________________________________ Begin/end dates (month/year) _______________
Type of Ministry duties ___________________________________________________________________________
Please select all Ministerial experience that applies:
Bishop
Pastor
Co-pastor

Associate Pastor
Youth/Childrens ministry
Music

Administration
Elder/Armor bearer
Fundraising

Video/Tape ministry
Dance ministry
Sunday school

Mail / Return your application to:

5109 W. Thomas Rd. Phoenix, AZ. 85031 Office Number: 602-269-6959 / Fax 602-269-7933

Statement of Truth

I understand that all items submitted to AZUSA World Ministry Training as a part of the application process
become the permanent property of AZUSA WORLD MINISTRY TRAINING INSTITUTE and will not be
returned to me. All information submitted to AZUSA World Ministry Training Institute is strictly confidential
and will not be released to any party without written request directly from the student. All students must
provide written requests when requesting transcripts or other documentation from the school.

I hereby state that the information contained in this application is correct and true. If AZUSA WORLD
MINISTRY TRAINING INSTITUTE is notified that any information contained herein is false, it will be
grounds for my immediate denial or dismissal. I also understand that completion of this application in no way
guarantees or imply acceptance and/or enrollment as a student at AZUSA WORLD MINISTRY TRAINING
INSTITUTE

Signature: __________________________________________________________ Date: ______/______/_________

By signing this application you certify that the information you provided is true and complete to the best of your knowledge.

PLEASE REMIT APPLICATION/REGISTRATION FEE WITH THIS APPLICATION

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Mail / Return your application to:

5109 W. Thomas Rd. Phoenix, AZ. 85031 Office Number: 602-269-6959 / Fax 602-269-7933

AZUSA WORLD MINISTRIES TRAINING INSTITUTE

Automatic Credit Card Billing Authorization Form

If you would like to enjoy the convenience of automatic billing, simply complete the credit information section below
and sign the form. All requested information is required. Upon approval, we will automatically bill your credit card for
the amount indicated and your total charge will appear on your monthly credit card statement. You may cancel this
automatic billing authorization at any time by contacting us in writing or by selecting the onetime payment option.

Credit Card Information ( To be completed by Customer)

AZUSA World Ministry Training Institute (Accreditation by) Friend International Christian University accepts the
following credit/ debit cards: Visa, Master Card, American Express and Discover. All information listed below is
required to process the automatic payment.
Cardholders name: (as it appears on your card): ________________________________________________________
Credit Card Type: _____________ Credit Card Number: _______________________________ Expires _____/______
(month & year)

Billing Address: __________________________________________________________________________________

Cardholders Signature/ E- Signature: ____________________________________ Date: _______/_______/_________

Customer information (To be completed by AZUSA WORLD MINISTRY TRAINING INSTITUTE )

FOR OFFICE USE ONLY
Customer name:__________________________________________ Phone number: __________________________
Payment Information (To be completed by AZUSA WORLD MINISTRY TRAINING INSTITUTE)

I authorize AZUSA World Ministry Training Institute (Accreditation by) Friends International Christian University to
automatically bill the card listed below as specified:
Amount $ _______________________ Begin billing on date: _____/_____/______ End Billing:_____/_____/_______
Frequency: One Time

Weekly

Bi- Weekly

Semi- Monthly

Payment in full

Customer provides written cancellation Date: _______/_______/___________

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Mail / Return your application to:

5109 W. Thomas Rd. Phoenix, AZ. 85031 Office Number: 602-269-6959 / Fax 602-269-7933

APPLICATION / REGISTRATION FEE PAYMENT

Please do not fill out
FOR OFFICE USE ONLY
DATE OF ACCEPTANCE:____________________________________________

DATE POSTED:____________________________________________

CASH

$________________________________________________

CHECK
#___________________________ $________________________________________________

CASHIER CHECK
#___________________________ $________________________________________________

MONEY ORDER
#___________________________ $________________________________________________

CREDIT CARD TYPE:

Debit Card

CARD NUMBER: ________________________________________________

America Express

EXPIRATION DATE:________________________________________________

Discover

AMOUNT AUTHORIZED: $________________________________________________

Master Card

BILLING ZIP CODE:________________________________________________

Visa

NAME ON CARD:________________________________________________
AUTHORIZING SIGNATURE:________________________________________________