Enrollment Form

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This field is for validation purposes and should be left unchanged.

Date(Required)

You understand that you must be (and are) at least 18 years of age or older to enroll with PDSOM, regardless of track.

Birth Date(Required)

Name(Required)

First Last

Email(Required)

Phone(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Credentialing Track, Bible Institute Track, Arabic School of Ministry (ASOM) or Board Track?(Required)

Credentialing Track goes towards you getting your Credentials with the Assemblies of God. Bible Institute is to gain a deeper understanding of the Word, not towards Credentialing.

Select your preferred CAMPUS.(Required)

Desired Username(Required)

Choice 1

Desired Username(Required)

Choice 2

PDSOM Enrollment(Required)

Price:

Payment Method(Required)

American Express

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MasterCard

Visa

Card Number Expiration Date Security Code Cardholder Name

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