Semester Registration Form

Brookes Bible Institute - Semester Registration Form

An (*) denotes a required field.

Title:  *Name:


*Address:

*City: *State: *Zip:


*Home or Cell Phone:  Work Phone:

*Email:

Occupation:   Church You Attend:

Below, list the classes you wish to attend.


(Code): Class: Hours: x$50/hr = $    Morning  Evening

(Code): Class: Hours: x$50/hr = $    Morning  Evening

(Code): Class: Hours: x$50/hr = $    Morning  Evening

(Code): Class: Hours: x$50/hr = $    Morning  Evening

(Code): Class: Hours: x$50/hr = $    Morning  Evening

(Code): Class: Hours: x$50/hr = $    Morning  Evening

(Code): Class: Hours: x$50/hr = $    Morning  Evening

(Code): Class: Hours: x$50/hr = $    Morning  Evening


*Less 10% advance payment discount.

If you are returning to register for additional classes this semester, please uncheck
this box to remove the Student Services fee and Registration fee.

One Time Per Semester Fee = $


Late Enrollment Fee = $


Please order my text books.

ADD extra books and/or any other fees HERE = $


Total Cost = $


Check this box to pay online.
There is a 3% fee for online payments.

 


Click Here for a printable version of this page.


*NOTICE: IF YOUR BILL IS PAID IN FULL BY THE END OF YOUR FIRST CLASS,
YOU MAY HAVE A 10% DISCOUNT ON THE PER HOUR CHARGE.