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00 - Enrollment Agreement
  1. Note: This form must be completed and your first payment made within 30 days from the date of your acceptance letter.

    Items marked with a red astrisk (*) are required and must be completed.


  2. Your Name:(*)
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  3. Daytime or Cell Phone Number:(*)
    Please Enter Your Phone Number in this format: 123-456-6789
  4. Your Email Address:(*)
    Please Enter Your Email Address


  5. Acceptance Letter Agreement Section



  6. Please read each statement and indicate that you understand and agree by placing a checkmark in each checkbox.


    I understand and agree to the requirements of my degree program as stated in my acceptance letter.(*)
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  7. I understand that the total cost for my degree program is a legitimate debt owed to the International College of Ministry for my enrollment and I agree to remit to ICM all tuition and costs for my degree plan as shown in my acceptance letter. I understand that failure to pay can cause my debt to be assigned to a collection agency.(*)
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  8. I understand that I must complete ICM's Email & Student Account Registration Form found in the Student Resource Center before I can access my courses.(*)
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  9. Financial Assistance Section



  10. Choose One of the Following:(*)
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  11. Please select one of the following.(*)
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  12. Payments can be processed via credit card or bank transfer. Please choose the method you prefer and complete the appropriate section below.

    If you have neither credit cards nor a bank account, please enter special instructions here or contact ICM's admissions office to make special arrangements.
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  13. (Credit Card Option) Please select your initial choice for your payment plan (this information will be kept confidential). No payment will be run without your consent.

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  14. Name as Shown on Card
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  15. Enter Your Credit Card Number (16 digits with or without dashes)
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  16. Expiration Date
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  17. 3-Digit Security Code (On Back of Card)
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  18. Zip Code Where Bill is Sent
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  19. ACH Debit: (Bank Transfer Option)
  20. 9-Digit Bank Routing Number
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  21. Applicant's Electronic Signature:(*)
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  22. For Security,
    Please Complete this CAPTCHA Form to Show You are Not a Computer.

    (*)
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