Instructions:
Upper Midwest Extension Course of Study School An extension of Garrett-Evangelical Theological Seminary at Morningside College, Sioux City, Iowa Fall 2020 Registration FormInstructions:You must be under part-time appointment to register for a course at UMECOSS.If this is your FIRST time registering with UMECOSS, send a copy of your current License for Pastoral Ministry and a copy of your current health insurance card with your registration.Registration deadline for spring classes is June 15, 2020. Please enclose a $75 non-refundable registration fee. Checks should be made payable to the Iowa Annual Conference.Obtain the required signatures of your District Superintendent and your Annual Conference Registrar.Send completed forms and fees to Carl Phillips, UMECOSS Registrar, at the address below.Send a second copy of this form to Dennis Tevis, Director of UMECOSS, at the address below.Tuition payment of $200 is due one month prior to first class session. Late registrations will be charged a $25 late fee. Please fill in this form carefully so your information is legible; we build class lists from this information.Name (Last, First, MI) PID number (obtained from GBHEM)Address (Street/City/State/Zip)Home Phone:Work Phone:Cell Phone:Date of birth:(mm/dd/yy)E-mail:Denomination:Conference:District:Charge:If you have any special needs, please list them here:YesNoDate of Certification, etc.Certified Candidate?Local Pastor’s License?Currently under part-time appointment?YOUR ACADEMIC HISTORYHigh School/GEDYes_NoCollege/university # of hours:Degree awarded & date:Graduate school:Degree awarded & date:Seminary, # of hours:Where?PLEASE CHECK COURSE OF STUDY WORK ALREADY COMPLETED111/121 Bible I: Introduction211/221 Bible II:Torah and Israel Hist.311/321 Bible III:Gospels411/421 Bible IV:Proph/Psalms/Wis Lit511/521 Bible V:Acts/Epistles/Revelation112/122 Theology in the Wesleyan Spirit212/222 Theological Heritage: Early Church312/322 Theo Heritage: Medieval/ Reformation412/422 Theo Heritage: Wesleyan Movement512/522 Contemporary Theology113 Pastoral Care for Spiritual Formation___124 Leadership213/123 Formation and Discipleship313/523Evangelism413/223 Worship and Sacraments513/423 Mission ___ 114/224 Polity and Administration214/324 Practice of PreachingPrPreaching314/323 Congregational Care 414/424 Personal and Social Ethics514/524 Theo Reflect/Prac of Min MMMMinistryI hereby certify the information given is correct. I give permission to release my grades and pertinent information to the Board of Higher Education and Ministry of the United Methodist Church and to its counterpart in my annual conference. I recognize that participation in this event exposes me to hazards such as an automobile accident that may result in bodily injury and even death. For the opportunity to participate in this event, I am willing to accept these risks.I certify that I have health insurance in effect that will reimburse me for any medical expenses that I might incur. IF THIS IS MY FIRST REGISTRATION, A COPY OF MY CURRENT HEALTH INSURANCE CARD IS ATTACHED. In emergencies, please contact:Name:Relationship: ______________________________Phone#I certify that I have read the UMECOSS Handbook and Policies.458216016256000xSignature of ApplicantDate Please check the course for which you are registering:Fall 2020 – September 11-12 and October 23-24_____ 121 Bible I: Introduction_____ 124 Transformational Leadership_____ 224 Polity and Administration_____ 322 Theological Heritage III: Medieval through Reformation_____ 422 Theological Heritage IV: Wesleyan Movement_____ 523 EvangelismRegistration deadline: June 15, 2020 $25 penalty for registrations received after the deadlineUMECOSS Handbook and homework assignments can be downloaded from our web pages at .Contact information:Director: Dr. Dennis TevisRegistrar: Rev. Carl Phillips2539 Old Highway 1412133 E AvenueHornick, Iowa 51026Shenandoah, Iowa 51601e-mail: gtevis@e-mail: carlphillipssvf@Phone: 319-572-1940Phone: 712-370-7963District approval of applicant to attend Extension Course of Study School (COS)I approve the attendance of this applicant to the Course of Study at Upper Midwest Extension Course of Study School.Part-time Local PastorOther (please explain):xDistrict Superintendent SignatureDistrict Superintendent Name PrintedAddress (Street/City/State/Zip):E-mail Address:Date:xAnnual Conference Local Pastor Registrar SignatureAnnual Conference Local Pastor Registrar Name PrintedAddress (Street/City/State/Zip):E-mail Address:Date: ................
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