College Credit Application Form

Program Applying for: Program Applying for: Military & Law Enforcement Chaplain EMS Outreach Chaplain Biblical Studies Missions Church Administration Single Course

Full Name

Full Address

Email Address

Phone Number

Skype

Date of Birth

Place of Birth

Citizenship

Gender

Marital Status

Name of Spouse

Number of Children

Home Church

Pastor's Name

Church Address

Church Phone Number

If you are seeking College Credit, is your Pastor willing to work with you to accomplish your tests? If you are seeking College Credit, is your Pastor willing to work with you to accomplish your tests? Yes No Not Seeking Credit

Is your family in agreement with your educational desires? Is your family in agreement with your educational desires? Yes No

If no, please submit details:

Have you ever been arrested? Have you ever been arrested? Yes No

If yes, please submit details:

Parent's Name or Next of Kin

Relationship

Address

Phone Number

How do you intend to finance your education?

High School Attended

Highest Grade Completed

Year

GED

School Address

School Phone Number

Other Education - List other schooling (College, Vocational, Business, etc.)

Dates of Attendance

School Address

School Phone Number

Major

Degree or Diploma

Did you attend any other schools? Did you attend any other schools? Yes No

Other Education - List other schooling (College, Vocational, Business, etc.)

Dates of Attendance

School Address

School Phone Number

Major

Degree or Diploma

References (other than relatives) Pastor

Address

Phone

Reference 2

Address

Phone

Reference 3

Address

Phone

How were you saved?

Give a brief statement of your Christian service to date:

What are your plans when you finish college?:

Why did you choose Dayspring Bible College & Seminary Distance Learning?:

By clicking send you agree that “I do hereby make application for the Dayspring Bible College & Seminary Distance Learning Program, and agree, if accepted, to cheerfully abide by all rules and regulations and cooperate fully in every respect in advancing the Christian testimony of the Dayspring Bible College & Seminary. I have read the Catalog, including the Statement of Faith, and am in full agreement with its policies, procedures, and other information contained therein.”