Preferred Title: Mr., Mrs., Ms, Rev, Pastor, Rabbi, Elder, Imam, Father, Sister, other
Name - First, Middle Initial, Last:
Best Phone Number
Subject(s) of interest
After completion of study, what is your goal?
Apt. / Unit #
City / Town name:
State / Province:
Zip / Postal Code
Country / Nation:
I am interested in the following (it is fine to select more than one button)
Ordination to clergy
Earn CPE units
Small Radio/TV station
Have a computer and are comfortable with its use?
Faith? (Protestant, Catholic, Jewish, Other:
Denomination (Okay if none)
Occupation (if any):
Job Title or Description of your Duties:
Seeking a Promotion in Current Job?
maybe - Undecided
I am just looking
Seeking a Career Change?
Maybe - undecided
I am very interested in enrolling in an online course at the seminary
Name of EMPLOYER (official company name). Please estimate year started working there
Education: Did not complete High School. Give details, only if desired
GED - may give further information if desired
Technical school or special studies: Describe, please. Also, did you complete these studies? Give the year you concluded these studies:
Bachelor's Degree - major - did you complete? How many credits did you earn?
Exact name(s) of College or University where you earned
Bachelors - if applies. What was your major? Year graduated:
Master's degree - major - did you complete? How many credits earned?
Exact name of Masters college/university -- and department name (if applies)
Doctoral studies - major - completed? Current status
Please attach a RESUME if available
I will be able to pay my full tuition upon enrolling (typical)
I will need to request your interest-free tuition donation program
One final detail and then you're done. Please give us a description of the type of studies you hope to enroll in at the seminary. And, of course, please use this space to ask any questions you may have!
Other things you would like to bring to our attention: