SDIM Student Registration
Please complete this form to register for a course.
Student Name
*
First Name
Last Name
Student Email
*
example@example.com
Student Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Student Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Student's Church
*
Please list the number of the course for which you are registering.
*
Please list the title of the course for which you are registering.
*
Please list the location where the course is being taught, if known.
Please select the ministry track you are following:
*
Elder
Deacon
Audit
Payment Options:
1. Please mail a check to SDIM Director Dan Anderson: 6235 S. Walnut Street, Loomis, CA 95650
2. Pay online here
Course Fees
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( X )
Tuition & Registration per course
$225.00
$
225.00
Quantity
1
2
3
4
5
6
7
8
9
10
Audit & Registration per course
$125.00
$
125.00
Quantity
1
2
3
4
5
6
7
8
9
10
Item subtotal:
$0.00
$
0.00
Debit or Credit Card
First Name
Last Name
Credit Card Number
Security Code
Expiration Month
January
February
March
April
May
June
July
August
September
October
November
December
Expiration Month
Expiration Year
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
2036
2037
2038
2039
2040
2041
2042
2043
2044
2045
Expiration Year
Submit
Should be Empty: