For Office Use Received___________ Fr. Tr. Spec Notification ________ ______App fee ______Photo ______High School Trans ______College Trans ______ACT ______Reference ______Reference ______Reference ______Med Form
APPLICATION FOR ADMISSION
Ph: (336) 744-0900
Please print in ink or
typewrite
Answer ALL questions completely
I. PERSONAL
INFORMATION
Miss
Name Mrs.
Mr.__________________________________________________________Soc.
Sec#_______________________________
Last
First
Middle
Permanent
Home Address
______________________________________________________________________________________
Number and Street
__________________________________________________________________________Telephone#________________________
City State Zip
Date of
Birth _______________________________________Place of
Birth_______________________________________________
Marital
Status: Single_____________________
Married__________________________Separated____________________________
Divorced
___________________Widowed_________________________
If
married, give name of spouse
_____________________________________________Number of
Children_____________________
Name of
Parent(s) _________________________________________Phone of Parent(s)
_____________________________________
Address
of Parent(s)
___________________________________________________________________________________________
Citizenship:
(If other than
If you
are not a
If so,
give name and address of nearest relative in the
Name
____________________________________________________________________________________________________________
Number and Street
City
State
Zip
Are you
in good health? Yes___________________
No___________________________
If not,
state briefly the nature of your illness or disability
_______________________________________________________________
Have you
ever received treatment for emotional or nervous disorders,
or has professional counseling ever
been recommended for such?
Yes_____________________
No____________________
Do you
use tobacco in any form, alcoholic beverages, or illicit narcotics? Yes
______________________No____________________
Have you ever been convicted for anything other than minor traffic violations? Yes
____________________No____________________
(IF THE ANSWER TO ANY OF THE LAST
THREE QUESTIONS IS YES, PLEASE WRITE AN EXPLANATION OF YOUR ANSWER ON A
SEPARATE PAGE.)
II.
EDUCATIONAL INFORMATION
Are you
a high school graduate? Yes_____________________
No _________________________Date of Graduation _____________
If you
are still in school, give date of anticipated graduation
_____________________________________________________________
If you
did not finish high school, how many years did you attend?
________________________________________________________
Name and
address of high school you last attended
___________________________________________________________________
Name Number and
Street City State Zip
Have you
attended any college, university, or technical school? Yes ____________No____________ If so, give
the name of each, the
degree
received, or semester hours earned.
__________________________________________________________________________
If you
desire to transfer from another college, give reasons ______________________________________________________________
Have you
ever been denied admission, suspended, or expelled from any
college? Yes_______________ No ________________________
(If so,
please explain)___________________________________________________________________________________________
List the
activities in which you participated in high school and/or
college___________________________________________________
III.
CHURCH INFORMATION
Are you
an immersed believer in Jesus Christ?
Yes ________No __________
Name and
address of church where you are a member
_________________________________________________________________
Name
_______________________________________________________________________________________________________________________________________
Number and Street
City State Zip
Name and
address of home minister
___________________________________________________________________________________________________
Name Number
and street
City
State
Zip
In what
capacities do you serve in your home church?
_________________________________________________________________
IV.
FINANCIAL INFORMATION
Will you
be able to pay, at registration, your first semester charges? Yes________ No ____________
What will
be the source of your financial support while in college?
________________________________________________________
V.
ENROLLMENT PLANS
For what
field of activity do you want to prepare?
_____________________________________________________________________
Do you
intend to enroll as:
Full-time Student_____________________________ Part-time Student
____________________________
What
degree will you seek from WSBC? What
minor do you plan to pursue in your degree program?
______
Bachelor of Arts in Ministry ______
Biblical Languages
______Associate
of Arts in Ministry ______
Christian Education
______Non-major ______
Pastoral Ministries
______
Undecided ______
Urban Ministries
I plan
to enroll in WSBC beginning with the: Fall semester______________________ Spring
semester _______________________
Year
Year
***PLEASE WRITE HERE ANY LENGTHY ANSWERS TO QUESTIONS AND
ADDITIONAL INFORMATION WHICH YOU FEEL WILL BE HELPFUL
IN CONSIDERING YOU APPLICATION.
***PLEASE WRITE A SHORT ESSAY ON THIS
SHEET STATING YOU GOALS AND REASONS FOR ENROLLING IN
Please
sign below to indicate that:
(1) The contents of this form are true and
complete.
(2) I have read the purpose and policy of
____________________________________________________________________________________________________________
Signature
Date
(336) 744-0900
www.WSBC.edu