Enrollment Information
Program Applying for:
Military & Law Enforcement Chaplain
EMS Outreach Chaplain
Biblical Studies
Missions
Church Administration
Single Course
Biographical Information
First Name Last Name Middle Name
Permanent Address City, State, ZIP
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 City, State, ZIP Phone
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?
Yes No
If no, please submit details:
Have you ever been arrested?
Yes No
If yes, please submit details:
Parent/Next of Kin Relationship
Address City, State, ZIP Phone
How do you intend to finance your education?:
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High School Highest Grade Completed
Year GED
School Address City, State, ZIP Phone
Other Education - List other schooling (College, Vocational, Business, etc.)
1. Name of School Dates of Attendance
School Address City, State, ZIP Phone
Major Degree or Diploma
2. Name of School Dates of Attendance
School Address City, State, ZIP Phone
Major Degree or Diploma
3. Name of School Dates of Attendance
School Address City, State, ZIP Phone
Major Degree or Diploma
References (other than relatives):
1. Pastor Address City, State, ZIP
Phone Email
2. Name Address City, State, ZIP
Phone Email
3. Name Address City, State, ZIP
Phone Email
How were you saved?:
Give a brief statement of your Christian service to date:
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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.�