We offer a fully accredited biblical studies program. Not only do we want you to know the Word of God, but we want you to apply it and have a growing relationship with Jesus Christ!
Please fill out each blank on this application. When finished click the Submit Application button at the bottom of the form. Please note that the $20 application fee is required and may be paid after you have submitted your application via mail, or it will be applied to your school bill when you arrive for school.
Indicate what year and campus location you will begin your studies: 2013 2014 Ontario, Canada New York, U.S.A. Florida, U.S.A.
1. Legal Name Last: First: Middle:
Date of Birth: Preferred Name:
Social security/Social Insurance No: (optional but speeds Financial Aid process)
2. Home mailing address:
City: Prov/State: Postal/Zip Code:
3. Phone: Cell:
E-Mail Address:
4.County of Citizenship: Canada U.S.A. Other:
If other: Country of birth:
Residency: Landed Immigrant of Canada Permanent Resident of U.S.A. Neither
5. Gender: Male Female
Ethnicity: African American Asian Caucasian Hispanic Native American Other Marital Status: Single Engaged Married Widowed Remarried SeparatedDivorced
Name of fiancé/spouse:
If married, names and ages of children:
Highest number of education completed: Grade 11Grade 12GEDCollage/Bible Institute 1Collage/Bible Institute 2Collage/Bible Institute 3Collage/Bible Institute 4Post Graduate 1Post Graduate 2Post Graduate MAPost Graduate PhD
1. High school: City: Prov/State:
Real or Expected Graduation Date: Diploma Type:
Extra Curricular Activities:
2. Have you ever been dismissed from a school? Yes No
If so, where and why?
3. Have you ever been diagnosed with a learning disability? Yes No
4. Do (did) you have a 504 plan or IEP in high school? Yes No If yes, please have a copy forwarded to our office.
1. Do you have any health condition that requires special attention? Yes No
If so, explain
2. Do you have a physical handicap that might need special attention to participate in our program? Yes No
3. Have you received professional treatment/counselling of a mental/emotional condition? Yes No
If so, list dates and explain
4. Do you take any medication on a regular basis?
Father's Name:
Address:
Phone:
Mother's Name:
1. Parents are: Married Divorced Separated Father deceased Mother deceased
If parents are divorced/separated, do you live with your father or mother?
If not living with parents, Legal Guardian Name:
2. When was the last time you used: Tobacco: Alcohol:
Drugs/Marijuana:
3. Have you ever been convicted of a crime? Yes No If so explain
4. Have you ever been in prison? Yes No If so explain
5. Are you or have you ever been on probation? Yes No If so explain
1. Please complete the following information on the local church where you attend:
Church's Name: Denomination:
Are you a member? Yes No If no, do you attend this church regularly? Yes No
2. Date/Year of salvation:
3. What do you believe is necessary for salvation?
4. Do you have assurance of you salvation? Yes No
On what Scripture do you base this?
5. Are there any circumstances that could casue you to lose your salvation? Yes No
6. Have you read and are willing to submit to the teaching standards set forth in the Statement of Faith? Yes No
If not, in what areas do you disagree?
7. Have you read and are you willing to abide by the Standard of Conduct while a student? Yes No
8. How did you first hear about the Bible Institute?
9. Who or what was instrumental in your decision to apply to Word of Life Bible Institute?
1. Please write your salvation testimony and the circumstances surrounding your salvation experience.
2. Please briefly describe your current devotional and church/ministry involvement.
3. How do hope to benefit from your time at Word of Life Bible Institute?
