Office Use Only

$25.00 App Fee

Testimony:

Letter of Reference:

Confirm. Email Sent:

Request Sent:

Letter of Acceptance:

Transcripts:

Ministry Experience:

Program:

Down Payment:

Books Shipped:

Request Sent:

Other:

Application

Name (As if on Degree):

Maiden Name:

Email Address:

2nd Email

Phone:

Work Phone:

Cell Phone

SSN:

Current Address:

Date of Birth

City

State:

Zip:

Country:

Employment Information:

Current Employer:

Immediate Supervisor:

Length of Employment?

Position:

Employers Address:

City

State

Zip

Phone:

Email:

Fax:

Personal Information

Emergency Contact

Phone

Email (required)

Spouses Name

# Of Children

Names And Ages

Educational Information

High School

Location

Credits

Degree

Date

College

Location

Credits

Degree

Date

Grad College

Location

Credits

Degree

Date

Please have your colleges (secular/Christian) send transcripts directly to SBC

Faith Information

Have You Recieved Jesus as your personal Savior as given in John 3 and Romans 10:9-10

Yes

Testimony

Fill Out Your Testimony on how you came to know the Lord as your personal Savior in the block below.

Name and address of Church you attend

Pastors Name and Phone Number

Are you involved in any of the following areas

Do You Smoke

Yes

Drink Alcohol

Yes

Homosexual Relationships

yes

Extra-Marital Sex

yes

Illegal Substances

yes

Pre-Marital Sex

yes

Pornography

yes

Hate Groups

yes

A "yes" answer on any above question does not neccesarily exclude you from being accepted as a student. If yes is answered on any of the above and is within the last three years please explain

By signing this document I am stating that I am in agreement with the statement of faith and purpose, the rules of conduct, grievance procedure, and the pledge for students (see website). I realize that I have answered these questions to the best of my ability and I further realize that any false statements on this application are grounds for immediate dismissal from the college without refund.

Name

Date

I realize that by filling in the Block Above (Name Block) and by filling in the date, that I am electronically signing this document and that this is valid and is considered an authentic electronic signature.

Others Who Would Be Intereseted In SBC

Name

Address/Phone/Email

Name

Address/Phone/Email

Ministry Experience

Please fill in the description of the ministry, dates, and hours or enter N/A if you have no ministry experience in any area.
Include for each checked item: Dates (From/To) / Name of Group / What I did in this ministry / Hrs per week / Total Hours

How many total hours of ministry experience do you have?

Pay your Application Fee, now.

By checking this box I agree that I will be sent to the Summit Bible College website at www.summitbiblecollege.com and pay by clicking on the Paypal icon, now, and pay my application fee.

Indicates Response Required