Ministerial Student Secure Enrollment Form

* Required Field

Student Information

/ /
Month     Day       Year

Contact Information

Mailing Address


Residential Address ( )



Highest Level of Education *

Purpose For Enrollment

Must be recommended by local church and DBMD (Ministerial students, licensed ministers)

Ministers ordained outside the Wesleyan church wishing to join The Wesleyan Church. Transferring ministers must submit transferring ministers application to the General Superintendents office at Headquarters and be recommended by your district superintendent.

Lay person in a local church/district setting, with specialized area of ministry. Area of Specialty for Special Worker

Local Church License only; not a vocational pastor/staff pastor

Form Fee

You qualified to have the Form Fee waived!

A $20.00 fee is required for this enrollment to be processed.

Make checks payable to Education and Clergy Development. Mail check for $20.00 to:

Education and Clergy Development
13300 Olio Rd., Fishers, IN 46037

Month     Year


Billing Address On Credit Card Statement ( )



Release Permission

I hereby grant permission to The Wesleyan Church Education and Clergy Development Division to release any records of my work or personal information for the purpose of informing the General Church, its district leaders, or its boards concerning my progress in and completion of the course requirements and other data as needed.

Please type your full legal name: Enrollment Date: 09/29/2022

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