Course 201 New Student Application Instruction Page © Freedom House Ministries February 2020

Course 201 NEW STUDENT APPLICATION – INSTRUCTION PAGE How to Apply by Mail OR Electronically

Step One: Fill-out Application by Paper or Electronically

Paper Application Electronic Applicaton

1. Print Application.

2. Using a black pen, complete information.

3. Sign (also spouse if applicable) under #2 on Pg 3.

4. Determine your Costs on Pg 4.

5. Make a copy of all 4 Pgs for your files.

1. Complete PDF fillable Application Pgs 1-4.

2. Sign your name (also spouse if applicable) under #2 on Pg 3. (Typing your name here is equivalent to an ink signature.)

3. Determine your Costs on Pg 4.

4. Save a copy of the completed Application on your computer.

Step Two: Determine Method of First Payment – Check or PayPal

Payment by Check Payment by PayPal

1. Check is payable to Freedom House Ministries. Send to (include Application if registering by paper): The Andersens, Freedom House Ministry, 3217 Scoville Ave, Berwyn IL 60402-3546

2. If registering after last Wednesday in August, Late Fee of $35 can be added to your Application check.

1. PayPal link: Course 201 New Student Scroll Down to “Buy Now” to use PayPal or Credit Card. The PayPal Fee ($15/$25) is included in the PayPal drop-down menu payment.

2. If registering after last Wednesday in August, Late Fee of $35 is paid online separately from School Cost.

Step Three: Determine Method of Submitting Your Application

Submit Application by Mail Submit Application by Email

1. Mail in original Application, Pgs 1-4 to: The Andersens, Freedom House Ministry, 3217 Scoville Ave, Berwyn IL 60402-3546

2. Include your first payment if paying by check.

1. Email Application as an attachment to: marianne@freedomhouseministry.com

Step Four: Complete Pastoral & Character References

References Sent by Mail References Sent by Email

Print out each Reference form and prepare two envelopes to: The Andersens, Freedom House Ministry, 3217 Scoville Ave, Berwyn IL 60402-3546

1. Give Pastoral Reference to your Pastor or ministry leader with a pre-addressed envelope.

2. Give Character Reference to your friend/neighbor/co-worker (not a family member) with a pre-addressed envelope.

Completed Reference forms are to be mailed directly to Mari Anne Andersen by the last Wednesday in August.

1. Email Pastoral Reference to your Pastor or ministry leader.

2. Email Character Reference to your friend/neighbor/co-worker (not a family member).

Completed Reference forms are emailed directly to Mari Anne Andersen by the last Wednesday in August at: marianne@freedomhouseministry.com

OR

OR

OR

OR

Any questions or problems completing these steps? Contact Dorie at drlorden@att.net or 224-434-1200.

OR

CLICK HERE TO EMAIL APPLICATON

Course 201 New Student Application © Freedom House Ministries February 2020

Course 201 NEW STUDENT APPLICATIONFacilitated Elijah House Video School-Prayer Counseling Ministry Training

Contact Information:

Select all that apply: Mr. Mrs. Ms. Miss Pastor Widow Single Parent Non U.S. Citizen

Name

Age

Address

Spouse

City

Best Contact Number:

Is this your Cell Home or Work

Can we text you? Yes No

State

Fax

Zip +4

Email

Church

Occupation

Note to Married Couple:

Each person completes pages 1 – 4 of this Application. One person completes Student Costs on page 5 of this Application.

Each person is to submit a Pastoral Reference form and a Student Character Reference form. Click here to download the forms. Instructions for completing and submitting forms are in the download.

Before You Begin the Following Sections See the Instruction Page for Details & Checklist

Question & Answer:

1. Which of the following Elijah House books have you read?

▢ Healing Women’s Emotions

▢ Restoring the Christian Family

▢ God’s Power to Change

▢ Transforming the Inner Man

▢ Choosing Forgiveness

▢ Healing Victims of Sexual Abuse

▢ Why Good People Mess Up

▢ Growing Pains

▢ Letting Go of Your Past

▢ Deliverance and Inner Healing

▢ Other books on inner healing and transformation that you have read:

Name ________________________________________Page 2 of 4

Course 201 New Student Application – Single or Married Couple Students © Freedom House Ministries February 2020

2. What other prayer ministries have you been involved with?

3. How long have you been a Christian?

Years Date of Salvation

4. Please give a brief account of when and how you became a Christian.

5. How are you presently serving the Lord? Are you presently ministering to others? If so, how?

6. What is your primary reason for attending Course 201?

Name ________________________________________Page 3 of 4

Course 201 New Student Application – Single or Married Couple Students © Freedom House Ministries February 2020

7. Are you receiving prayer ministry or counseling at this time? If so, briefly explain:

8. Have you or are you presently taking medication for any symptoms* in the statement on page 4? If so, explain briefly:

9. How did you hear about Course 201?

10. Additional Comments:

Name ________________________________________Page 4 of 4

Course 201 New Student Application – Single or Married Couple Students © Freedom House Ministries February 2020

Read Policies and Disclosures & Sign Below:

1. Application Policies:

Due to the fact that we are dealing with the hearts of people, the School can, at times, be very intense. Personal responses to teaching and small group interaction may include, but are certainly not limited to, some of the following: *expression of anger, prejudices, resentments, apprehension, anxiety, insomnia, depression, dissociation. Because of time restraints, all of your personal issues will not be dealt with during the course of the School. This is a lifelong process. However, we do give you the tools to pursue further healing, and you may want to pursue further ministry once the School is complete. If you feel there are already significant life issues that need to be addressed, ministry or counseling prior to your enrollment in the School is advisable and always beneficial.

If you have been seeing a counselor/therapist, it is our policy that you discuss the School with them and receive their approval by filling in this information:

Counselor Name:

Work Phone: Cell Phone:

Address:

City: State: Zip:

2. Down Payment and Required Book Disclosures: I understand that once I have paid the Down Payment for Course 201 and my Required Books and Manual have been ordered from Elijah House, my Down Payment is not refundable and the Books and Manual themselves that I have ordered are not returnable to Freedom House. I understand that my signature testifies that all information provided is true, that I accept the terms of enrollment Application Policies and I will provide sufficient funds in a timely manner for my participation in Course 201 School. Having accepted the School enrollment information and requirements outlined online, I respectfully submit my application. I agree to respectfully abide by the determination of the Freedom House facilitator as to the suitability of my attendance at this time. I agree to indemnify and hold Elijah House and Freedom House and their staff and volunteers harmless for any of my personal responses to the teachings and small group ministry times during the School. I also agree to indemnify and hold Elijah House and Freedom House harmless for any costs in time, travel, accommodations, or other incidentals, should the School be cancelled, my acceptance be delayed, or I am asked to discontinue Course 201 School to seek ministry or counseling before continuing at another time. _________________________________________________________________________________________ APPLICANT’S SIGNATURE DATE _________________________________________________________________________________________SPOUSE’S SIGNATURE DATE (This signature is needed ONLY if attending course without spouse.) NONDISCRIMINATORY POLICY CONCERNING FREEDOM HOUSE MINISTRY - Freedom House Ministries Inc. admits students of any race, color, nationality, or ethnic origin to all the rights, privileges, programs, and activities generally accorded or made available to students at its Schools. Freedom House Ministries Inc. does not discriminate on the basis of race, color, nationality or ethnic origin in the administration of its educational policies, admission policies, scholarships, loan programs, or any other administered school programs.

(typing your signature here is equivalent to ink signature)

Name ________________________________________Page 4 of 4

Course 201 New Student Application – Single or Married Couple Students © Freedom House Ministries February 2020

Course 201 NEW STUDENT COSTS

1. INCLUSIVE SCHOOL COST SINGLE STUDENT MARRIED COUPLE

Elijah House Tuition 99.00 198.00

Course Manual 50.00 100.00

6 Course Textbooks 90.00 90.00

Shipping/Handling 15.00 20.00

Facilitator Fee & Overhead Expenses

275.00 455.00

TOTAL SCHOOL COST $529.00 $863.00

1. $529 OR $863

2. PAYPAL PAYMENT FEE $15.00 $25.00

2. $0 or $15 or $25 3. LATE FEE $35.00 $35.00

3. $0 or $35 GRAND TOTAL

OF 1, 2 & 3

REGISTRATION & PAYMENT: By Mail or Online Due by Last Wednesday in August to avoid Late Fee

Be sure to keep photocopies or electronic copies of your application materials for your own files.

Payment Paid by CHECK Materials Sent by MAIL

Payment Paid ONLINE Materials Sent ELECTRONICALLY

Include Check of GRAND TOTAL OR MINIMUM DOWN PAYMENT (Single $260/ Couple $400) mailed in with Application.

Check made payable to Freedom House Ministries.

Late Fee can be added to Minimum Down Payment

check.

Using PayPal submit GRAND TOTAL OR MINIMUM DOWN PAYMENT (Single $260/ Couple $400) and submit Application

via

email.

Freedom House Ministry/Course 201 Scroll Down to “Buy Now” to use PayPal or Credit Card. PayPal Fee ($15/$25) will be applied.

Late Fee

can

be

paid

online

separately

from

School Cost.

If paying MINIMUM DOWN PAYMENT today, the remaining balance due is $________

Pay this amount on the first Day of School by check or cash.

If paying MINIMUM DOWN PAYMENT today, the remaining balance due is $________

Pay this amount before first Day of School on PayPal OR on the first Day of School by check or cash.

CLICK

HERE

TO

EMAIL

APPLICATION

Email Application as attachment to: marianne@freedomhouseministry.com

OR

Send

Application

(pgs.

1-4)

by

mail:

The

Andersens,

Freedom

House

Ministry,

3217 Scoville

Ave,

Berwyn

IL

60402-3546