KINGSWAY CHRISTIAN COLLEGE and THEOLOGICAL SEMINARY
3415 3rd St. Des Moines IA, 50313

APPLICATION FOR ADMISSION

1. Last Name: First Name: Middle Name: 
Email Address: Age: Sex:
 
2. Mailing Address:
Street: City: State: Zip:
 
3. Permanent Address (if different):
Street: City: State: Zip:
 
4. Telephone No.: Date of Birth:
 
5. Social Security # Height: Weight:
Hat Size: Hair Color: Eye Color:
 
6. Marital Status: Spouse (Name):
Number of Children:
 
7. Educational background: Name of High School:
Graduate/GED: Yes No
Year graduated: If not a graduate, show highest year completed: 
( 9 10 11 12 )
 
8. College or Specialized training; ( Yes No ) 
List College(s) and type(s) of degree(s) presently held:

 
9. What type(s) of ministry are you presently involved in? (Be specific)

 
10. What are your ministry goals?

 
11. How long have you been a Christian? (Write a brief conversion testimony)

 
12. Church you presently attend on a regular basis:
Address:
City: State: Zip:
Pastor's Name:  
Telephone #
 
13. Present Occupation:
Co./Org.:
Street: City: State: Zip:
 
14. Nearest Relative: Relationship:
Address:
Street: City: State: Zip:
Telephone No.: Telephone No. (Wk/Alt):
 
15.   Degree/Diploma desired: (Choose which you currently plan to apply.)
Diploma in Biblical Studies Associate in Biblical Studies
Associate in Theology Bachelor Master Doctorate
 
16. Field of Study(s) desired: (Choose the one for which you currently plan to apply.)
Theology (Divinity) Christian Counseling Pastoral Theology 
Christian Administration
 
17. Do you qualify for Advanced Standing Status? (Yes No)
I will send within 10 days a Christian service resume. ( Yes No )
 
18. I will send a recommendation for enrollment in this Christian College
from my Pastor or Christian leader who has known me for more than one year.
( Yes No )
 
19. I heard about Kingsway Christian College & Theological Seminary by:
Magazine Adv. Internet Pulpit Helps Personal Reference
If personal reference, give name of person referring: 

 
20. Health Status: Excellent Generally Good Average Poor
Major Health Problems:


Have you ever been treated for emotional/mental condition?  ( Yes No )
If yes, explain:

 
21. Have you ever been disciplined by a church, a pastor, 
or a Christian leader? ( Yes No )
If yes, explain:

 
22. Do you presently smoke, use narcotic drugs or alcohol; participate in 
child molestation, lesbianism, homosexuality, etc.? ( Yes No )
If yes, explain:

 
  Your application cannot be processed until the $25.00 application fee is paid.
Would you like to make this payment now?  Yes No