PERSONAL INFORMATION

 

First Name: _______________________________  Middle: __________________  Last:  __________________________________________

 

Mailing Address: ______________________________________________  City: ____________________  State: _______  Zip: __________

 

Home phone: (______) ______ - ________  Cell: (______) ______ - ________  E-mail address: __________________________________

 

Social Security #: ________-_______-___________    Date of birth: ____________________     U.S. citizen?  _____ yes     _____ no*

 

If no, of what country? _____________  If no, what is your immigration status? __________________________________________
                                                                                          (*non-U.S. citizens must provide proof of immigration status)

 

Race:  ______ African American       ______  Caucasian       ______  Hispanic         ______  Other: ___________________________

 

Marital status:    ____  Single       ____ Married      ____ Engage     _____ Separated      ____ Divorced      ____ Widowed

 

Name of emergency contact: _______________________________ Relationship: ___________ Phone: (______) ______ - ________

 

 

SPIRITUAL BACKGROUND

 

Name of church you attend: __________________________________________________________________________________________

 

Mailing Address: ______________________________________________ City: ______________________ State: ______  Zip: __________

 

Phone: (______) ______ - ________ Pastor: _____________________________ E-mail addresss: _________________________________

 

How long have you attended? ______________

 

If you have attended this church for less than two years please list the name of the previous church you attended:

 

________________________________________________________________________  How long did you attend? ___________________

 

Reason for leaving: ___________________________________________________________________________________________________

 

Have you received Jesus as your personal Lord and Savior? _________ When: _________________________________________

 

Do you sense a call of God on your life to enter full-time ministry?   _______ yes      ______ no

 

List the types of church-related activities you have participated in: ___________________________________________________

 

________________________________________________________________________________________________________________________

 

________________________________________________________________________________________________________________________

 

EDUCATIONAL BACKGROUND

 

Name of high school graduated: _____________________________________________________________________ Year: ___________ 

Please submit high school transcript or diploma. If you received a GED please write “GED” above and submit a copy of your GED.

 

City and State: ________________________________________________________________________________________________________

 

 

Have you attended any secondary educational institutions**?  ______ yes      ______no      If yes, please indicate below:

 

 

Name of School: ___________________________________________________________________ Dates Attended: _________________

 

Area of Study: ___________________________ Number of hours completed: _________  Graduated?   _____ Yes     ______ No  

             

 

Name of School: ____________________________________________________________________ Dates Attended: ________________

 

Area of Study: ___________________________ Number of hours completed: _________  Graduated?  _____ Yes     ______ No  

 

 

Name of School: ____________________________________________________________________ Dates Attended: ________________

 

Area of Study: ____________________________ Number of hours completed: _________  Graduated?  _____ Yes     ______ No   

                                                

**If you desire transfer credit, official transcripts must be submitted to our office before the application deadline.

 

 

OCCUPATIONAL BACKGROUND

 

Please list your previous work experience beginning with your current or most recent employer:

 

Name of Company: __________________________________________________________   Dates Employed: _____________________

 

Contact name and phone: ____________________________________________________________________________________________

 

 

Name of Company: __________________________________________________________   Dates Employed: _____________________

 

Contact name and phone: ____________________________________________________________________________________________

                                                                   

 

Name of Company: __________________________________________________________   Dates Employed: _____________________

 

Contact name and phone: ____________________________________________________________________________________________

                                                                    

                                                                  

Please list any special occupational or professional skills (you may include hobbies and special interests):

 

________________________________________________________________________________________________________________________

 

________________________________________________________________________________________________________________________

 

 

PASTORAL REFERENCE

 

To be considered for admittance to Kidron Christian College, each applicant is required to have one pastor recommendation completed. References are to be received directly from the pastor. Reference forms turned in by the applicant will not be accepted.  

 

Please submit the attached reference form along with a stamped envelope addressed to Kidron Christian College and Seminary to your pastor.

 

 

STATEMENT OF TRUTH

 

I understand that all items related to the submission of this application are part of the application process and become the permanent property of Kidron Christian College and Seminary and will not be returned to me. I understand that the application fee is nonrefundable. I hereby state that all the information contained on the recommendation form is confidential. I waive my right to see the confidential information contained therein and release said information to become the property of Kidron Christian College and Seminary. I also permit Kidron Christian College and Seminary to obtain any background information deemed necessary. I understand that the Kidron Christian College and Seminary is primarily a religious school. Credits are not guaranteed to be accepted by secular or state run programs. Accrediting Commission International is primarily a private school association unrelated to government accreditation.
 

 

_____________________________________________________________ Signature                            __________________________ Date                                                                        

 

Please submit this completed application to Kidron Christian College and Seminary:

 

PO Box 1201 Pocahontas, AR 72221 . 870-248-2222 . kidronchristiancollege.com

 

 

 

NOTICE

 

Upon your acceptance as a student at Kidron Christian College and Seminary, you will be required to sign a pledge to make a designated payment once a month, no exception, on any balance remaining on your tuition and any other fees.

 

 

 

To return to the online Student Application page, click here.