Application-Special

Special Circumstance
Application for Admissions

* Indicates required field

Name of student *

First

Last

Phone Number of student *

Email of student *

Address of student *

Line 1

Line 2

City

State

Zip Code

Country

Confirm Email address again please *

Do you have a High School Diploma/GED? *

YES NO

Do you have any college Degree? *

NO YES

If so, what is the degree in? Or put "none" *

Ministry Name of student or the name of the ministry they oversee *

Ministry Address *

Ministry Phone Number *

What Program are you applying for?: *

Is student a US Citizen? *

YES NO

Please explain what you are seeking and/or any special circumstance *

Gender *

Male Female

Date of Birth: *

How many years has student served in the ministry? *

Has student been given a minister's license by a local church body or organization? *

Yes, a minister's license only Both license and ordination Not licensed or ordained

Please describe your ministry involvements/activities *

If someone other than student is completing this information on their behalf, please give your name and all contact information, phone, email etc. *

I understand the following: *

I will receive a proxy agreement if I'm not the student completing this I will submit a copy of my photo ID with agreement

Print your full name as E Signature *