PART
I:
Name
(last) ______________________First Name_________________Middle________
Street
___________________________________ Email__________________________
City____________________State__________________
Country____________Zip__________
Home
Phone:____________________________Office Phone:______________________
Date
of Birth_______/_______/_______SSN______-______-______ Sex____________
Church
Membership_______________________________________________________
Pastor's
Name___________________________________________________________
Pastor's
Address__________________________________________________________
City___________________State___________________Country____________Zip__________
PART
II:
Christian
Life Experience (CLEP) you may apply for course credit toward part or all of
your Associate Degree. Please send a resume of Christ experience with documentation.
Total
years of Christian Service____________Type(s) of Service________________________
Education
(check all that apply):
High
School _______ GED_______ College Degree____________
List
all colleges, universities, schools and seminars attended. Include workshops,
certificate courses and other significant formal training.
Attach
legible copies of diplomas, certificates, transcripts or other verifiable documentation
of training. Evaluation for course credits will be made by the information you
supply.
School
or College Attended Location Dates Degree/Certificate
______________________________
_____________ ________ _________________
______________________________
_____________ ________ _________________
______________________________
_____________ ________ _________________
______________________________
_____________ ________ _________________
PART
III:
Application
Checklist
- __________I will like to enroll
for Christian Training.
- __________I have been called
to the ministry and I was to enroll.
- __________I am currently in
the ministry but I want more education or to continue my education.
- __________I desire a High
School diploma.
- __________I am a Pastor and
desire Diplomas for my graduating students.
- __________I have attached
a written account of my salvation experience.
- __________I have attached
a resume of my life, work and ministry experience (CLEP only).
- __________I wish to enroll
in the following checked program (check only one):
____Christian
Worker Certificate ____Teacher Certificate____Pastoral Certificate
____Assoc.
Degree_____Bachelors Degree_____Master Degree_____Doctor Degree
- __________I
have enclosed $50 ( U.S. nonrefundable Canada $85 nonrefundable) as the
application fee – If you are unable to pay this fee and you are in the ICOF
let us know.
Send the application anyway. Our first goal is education for those who want to minister.
- __________I have enclosed
a current photograph of me for school records.
______________________________________
___________________
Signature
of applicant
Date
________________________________________________
_____________
Signature
of applicant's parent (if applicant is under age)
Date
_______________
_________________________
________________
Print
Name
Signature
Date