APPLICATION FOR ADMISSION
FULL NAME ______________________________________________________
ADDRESS _______________________________________________________
AGE ______ DATE/PLACE OF BIRTH ___________ /____________________
HOME PHONE ________________ BUSINESS PHONE __________________
PLACE OF EMPLOYMENT _________________________________________
ADDRESS _______________________________________________________
NAME OF NEXT OF KIN ____________________________________________
ADDRESS _______________________________________________________
PHONE ____________________
NAME OF SPOUSE (IF APPLICABLE) _______________________________
HAVE YOU EVER BEEN DIVORCED? YES ______ NO ______
EDUCATIONAL BACKGROUND:
NAME OF HIGH SCHOOL _________________________________________
ADDRESS ______________________________________________________
YEAR GRADUATED ____________
PREVIOUS COLLEGE(S) (IF APPLICABLE) ___________________________
ADDRESS ______________________________________________________
CHURCH MEMBERSHIP __________________________________________
ADDRESS ______________________________________________________
ARE YOU OR HAVE YOU EVER BEEN A MEMBER OF THE MASONIC LODGE
OR OTHER SECRET SOCIETIES? YES ______ NO ______
(IF YES, PLEASE EXPLAIN)
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GIVE A BRIEF TESTIMONY OF YOUR SALVATION
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GIVE A BRIEF TESTIMONY REGARDING YOUR CALL TO THE MINISTRY
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REFERENCES:
YOUR PASTOR _______________________________________________________
ADDRESS ____________________________________ PHONE ________________
Application fee must accompany your application.
Tuition must be paid upon acceptance into the TH.G program.
I have read the doctrinal statement and I am in complete agreement with the beliefs and practices of this institution.
SIGNATURE OF APPLICANT ___________________________________________
DATE __________________
RETURN WITH $20 APPLICATION FEE TO:
PIONEER BAPTIST THEOLOGICAL SEMINARY
1001 SOUTH MARSHALL STREET, BOX 59
WINSTON-SALEM, NORTH CAROLINA 27101
