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 *

Gender *

Birth Date * Ex: 4/1/1988

Country of Citizenship *

Primary Language(s) *

Please Specify: *

International applicants are citizens of any country other than the U.S. and its territories who do not hold a U.S. green card for permanent residency.

Are you an international applicant? * YesNo International applicants are citizens of any country other than the U.S. and its territories who do not hold a U.S. green card for permanent residency.

Are you in the U.S. on a visa? * YesNo

What type of visa? *

When does it expire? *

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

To enroll in the Certificate in Missions and Montessori program you must meet the pre-requisite of having earned a One Year Certificate in Bible and Missions from Bethany College of Missions, or completed comparable training at another school.

Term *

I intend to enroll at BCOM as an Honor Academy Graduate Intern

I have been through the Honor Academy Roads Process and been approved to attend BCOM as a Missions GI

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/Program

Location of Program

Type of Program/Your Major

Start Date

Finish Date

Completed? YesNo

Graduation Date *

Were any of the college level credits earned at this school part of a dual credit program with your high school/PSEO? YesNo

Please explain any incomplete programs: *

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 Divorced: *

Date Separated: *

Date Widowed: *

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

What is your spouse's/future 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. *

Parents'/Legal Guardians' Names:

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

If you are under age 22 and unmarried, 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

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 you have outstanding debt, will it be paid off before your enrollment at Bethany? YesNoPartially

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.

Part 6 - Missions Information

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

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. *

Are you planning to or have ever lived, worked, or ministered outside your own country for any reason? YesNo

	Country	Organization you with which you worked	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:

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 *

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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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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