eChristian Education Form

First Name:

Last Name:

Preferred Name:

Address:

E-Mail Address:

Social Media Facebook, Twitter, etc.:

Phone Number:

Annual Conference or Christian Tradition:

Name of Annual Conference or Christian Tradition:

Certification Desired:

Highest Level of Education Completed:

Name of School(s) Completed:

Any previous Certification Courses taken:

Name of Courses:

Where Taken:

Who Offered the Course:

Application Fee $100.00
Each Class - $200.00
9 Classes X $200 = $1800.00 + $100 = $1900.00

Application fee, good for five years.

Students may pay by check. Checks should be made out to Martin Methodist College.

Payment should be mailed to:

Martin Methodist College
Center for Church Leadership
Attn: Tijunia Brooks
433 West Madison St.
Pulaski, TN  38478