Personal Information:
Last Name: First Name: MI:
Sex: Choose one... Female Male
Street Address:
City: State: Choose One... AK AL AR AZ CA CT CO DE FL GA HI IA ID IL IN KY KS LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VT WA WY WI VA WV Zip:
Home Phone: (no dashes) Office Phone: Cell Phone:
E-Mail Address:
Names of Parents, guardian or nearest living relative:
Their Address:
Date of Birth: Choose One Jan Feb March April May June July Aug Sept Oct Nov Dec / /
Do you have any special needs in order to attend class?:
Are you a baptized Christian?: Choose One... Yes No
If yes, what denomination are you a member, if any?:
Background Information:
Name of last high school attended: High school graduation year:
Address of high school:
GED certificate: Choose One... Yes No NA GED certificate year:
Have you taken the ACT?: Choose One... Yes No NA ACT score:
Have you taken the SAT?: Choose One... Yes No NA SAT score:
In what kinds of Christian ministry have you participated? (music, preaching, teaching, etc.)
College:
List all colleges attended. Include name, address, years attended and degrees received.
Name:
Location:
Years Attended:
Degrees:
Interest Information:
How will you be taking classes? Choose One... On Campus Online - Via Distance Learning Courses
What is your purpose for coming to ABC?:
If you are already committed to a church-related vocation, what is it? (preaching ministry, church music, Christian education, Christian missions, church secretary, other)
If not, how many years to you plan to attend?
Interview:
Preferred date:
Preferred time:
Phone interview: Choose One... Yes No
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