Apply

Part 1 - General Information

Last Name *

First Name *

Middle Name

Maiden Name

Preferred First Name

Street Number and Name *

Apt or Box Number

City *

State/Province *

Other State/Province *

Zip/Postal Code *

Country *

Hometown

City *

State/Province *

Other State/Province

Phone #

*

Email *

Part 2 - Academic Interest

Please select the program for which you are currently interested. This can be changed later, if desired.

Program *

To enroll in the Graduate Certificate in Christian Montessori Instruction you must meet the pre-requisite of having earned an AA degree or higher.

To enroll in the Certificate in Pre-field Preparation you must meet the pre-requisite of having earned an Associates degree in any field.

Term *

Part 3 - Education Information

Have you graduated from high school? * YesNoStill Enrolled

Graduation Date: (MM/DD/YY) *

Projected Graduation Date: (MM/DD/YY) *

Type of high school *

Have you earned a GED? * YesNot yetNo

Date you received your GED: (MM/DD/YY) *

Projected GED Finish Date: (MM/DD/YY) *

In which language(s) was your high school coursework presented? *

List any discipleship programs, certificate programs, high schools, or colleges you have attended, with the most recent listed first:

Name of Organization/Institution *

Location *

Type of Program/Your Major *

Start Date *

Finish Date *

Completed? * YesNo

Please explain any incomplete programs: *

Graduation Date *

Were any of the college level credits earned at this school part of a dual credit/PSEO program in which you earned both high school and college credit while taking courses? * YesNo

What was the primary language used in this college? *

I am/will be a graduate of Teen Mania Ministries Honor Academy. * YesNo

Graduation date: *

Please list any post-secondary credentials you have earned (ex: AA Degree in Business, TESL Certificate). *

Part 4 - Family Information

Marital Status and Children

Projected Wedding Date: *

Date Married: *

Date Widowed: *

Date Separated: *

Date Divorced: *

If you are divorced, separated, or widowed, please provide further information about your situation. *

What is your future spouse's full name? *

What is your spouse's full name? *

Are you a parent to any children? * YesNoExpecting a baby

Due Date: *

Please fill in for dependent children only:

	Child's Name	Child's Birthdate	Gender	Does the child live with you?
				YesNoPart time

If some or all of the children do not live with you or live with you only part-time please describe your situation and relationship with your children. *

Please select the description below which best describes your current living situation. *

Father's Name: *

Mother's Name: *

Father's Phone #:

*( )

* -

*

Mother's Phone #:

*( )

* -

*

Father's Email:

Mother's Email:

Mother's Name: *

Mother's Phone #:

*( )

* -

*

Mother's Email:

Father's Name: *

Father's Phone #:

*( )

* -

*

Father's Email:

Please provide at least one parent's address, phone, and email.

*

Street Number and Name *

Apt or Box Number

City *

State/Province *

Other State/Province *

Zip/Postal Code *

Country *

Please provide a parent phone number

*

Please provide a parent email address *

Please explain: *

Do your parents support your application to Bethany? * YesNoUnsure

If you marked no or unsure, please explain *

Part 5 - Financial Information

What is your current total debt? *$ ex. $0.00

If you have outstanding debt, please describe the type of debt (credit card, school loans, etc) and amount owed for each type. (If none, please write N/A) *

If you have outstanding debt, will it be paid off before your enrollment at Bethany? * YesNoPartiallyN/A

If no or partially, how do you plan to make payments while you are a student at BCOM? *

Please describe any other financial obligations you will have while attending Bethany. (If none, please write N/A)

Part 6 - Missions Information

How would you describe yourself as you consider a future role in cross-cultural missions? *

If other, please describe *

Are you interested in serving in a certain country? If so, please describe. *

Have you spent the majority of your childhood as the child of an overseas missionary? * YesNo

Please describe where you grew up and what kind of work you/your parents are/were involved in. *

Have you ever been in another country for ministry, study, military, or vacation? YesNo

	In which nation have you most recently visited/served as a missionary?	With which organization did you work/serve (if applicable)?	Dates of Travel	In what type of activities were you involved?

Part 7 - Personal Issues

Please note: Marking a "Yes" box will not automatically disqualify you for admission. However, misrepresentation of information may result in immediate disqualification or expulsion.

If you mark "Yes" for any of the Personal Issues below, please explain for each item in the box provided:

The dates, duration, and details
Any treatment received and its outcome
Any ways in which the issue(s) will affect you at BCOM (i.e. need for ongoing counseling, academic challenges, medical appointments, etc.)

Part 8 - Spiritual Life Information

Do you consider yourself to be a Christian? * YesNoUnsure

If you consider yourself to be a Christian, for how long? *

Please explain *

Do you attend church regularly? * YesNo

Please explain: *

Current Church Name *

Denomination *

How long have you attended here? *

City *

State/Province *

Country *

Does your church support your application to Bethany? * YesNoUnsure

If No or Unsure, please explain: *

Do you consider this to be your home church? * YesNo

Home Church Name *

Denomination *

How long have you attended here? *

City *

State/Province *

Country *

Please read Bethany’s Statement of Faith, below:

STATEMENT OF FAITH

We have been enlightened, enriched, and edified by many streams of Christian truth and do not seek to distinguish or divide ourselves from other members of the Body of Christ. This statement describes the fundamental truths in which we believe and by which we seek to live.

We believe the Bible to be the only inspired, inerrant, and authoritative Word of God.

We believe that there is one God, eternally existent in three persons: Father, Son, and Holy Spirit.

We believe in the deity of our Lord Jesus Christ, His virgin birth, His sinless life, His miracles, His vicarious and atoning death, His bodily resurrection, His ascension to the right hand of the Father, and His personal return in power and glory.

We believe that man was created in the image of God, that he was tempted by Satan and fell, and that all following Adam have sinned and are sinful; that repentance toward God, faith in Jesus Christ, and regeneration by the Holy Spirit are necessary for salvation.

We believe that followers of Jesus Christ are called to sanctification through identification with Jesus Christ in His death and resurrection.

We believe in the present ministry of the Holy Spirit by whose indwelling, empowering, and gifts the Christian is enabled to live a life of godliness and effective service.

We believe in the bodily resurrection of both the saved and the lost; the saved to the resurrection of life and the lost to the resurrection of damnation.

We believe that all followers of Jesus are to be committed to the fulfilling of the Great Commission, as found in Mt. 28:18-20, and to be involved in making it possible for the Gospel to be preached to all the peoples of the world.

* I am in agreement with the Statement of FaithI am not in agreement with the Statement of Faith

Please indicate the specific statements with which you disagree and explain: *

Part 9 - How did you hear about Bethany?

Who or what most influenced you in your decision to apply to Bethany? Please explain: *

How did you originally find out about Bethany?

*

Through what site, ad, link or search engine did you find out about Bethany? *

Name/relationship of the person who told you about Bethany: *

Name and approximate date of publication: *

Name, approximate date, and location: *

Please Specify: *

We would like to send you a free tee shirt! (Due to the high cost of mailing we are not able to send shirts outside of the US except to Canada. Thank you for your understanding.)

Please select a tee shirt size.

By submitting this application, I, the applicant, declare all information given in this document, and any additional written statements submitted in the application process, to be true and accurate to date. I understand that misrepresentation of information may result in immediate disqualification or expulsion.

* I have read and understand the above statement

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Apply

Financial Breakthrough

Application

Part 1 - General Information

Part 2 - Academic Interest

Part 3 - Education Information

Part 4 - Family Information

Part 5 - Financial Information

Part 6 - Missions Information

Part 7 - Personal Issues

Part 8 - Spiritual Life Information

Part 9 - How did you hear about Bethany?

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