Excel Bible College Student Application

NAME*

EMAIL ADDRESS*

DOB*

PHONE*

MAILING ADDRESS*

CITY*

STATE*

ZIP*

GENDER*

MARITAL STATUS*

Name of Spouse*

Spouse Email*

Spouse Mailing Address

Mailing Address City State / Province / Region ZIP / Postal Code

BACKGROUND INFORMATION (Information taken to better serve you as student)

Church :True Divine Baptist Church Pastor: Steven D. Huntley

EDUCATIONAL INFORMATION*

Name of High School City ZIP / Postal Code Country

Did you graduate?*

Date of High School Graduation

If you did not graduate, have you obtained a G.E.D*

When did you obtain G.E.D.?*

HIGHEST LEVEL OF EDUCATION*

DISCIPLINE/S*

Degree Applying for*

ADMINISTRATION/STUDENT FEES SCHEDULE:

Student’s Signature*

Date*

EMERGENCY CONTACT*

PHONE*

RELATION*

Address*

ADDRESS City State / Province / Region

Transcript*

PLEASE UPLOAD A COPY OF YOUR MOST RECENT TRANSCRIPTS.*

Max. file size: 2 MB.

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