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 $25 APPLICATION FEE TO:
PIONEER BAPTIST THEOLOGICAL SEMINARY
P.O. BOX 24051
WINSTON-SALEM, NORTH CAROLINA 27114
Phone: (336) 769-8946
E-mail: seminary@pioneerbaptist.net
