Great Lakes Bible College
Great Lakes Bible College Building Believers, Realizing Leaders www.glbc.ca
Application for Admission (R-16) Name
Date
PERSONAL INFORMATION Present Address __________________________________________________________ City _______________________ Prov/State _______ Zip/Postal Code______________ Phone _____________________ E-mail _______________________________________ Permanent Address (if different) _____________________________________________ City _______________________ Prov/State _______ Zip/Postal Code______________ Date of Birth ________________ Male Female Birthplace: Country ________________ Citizenship _____________________ Marital Status: Single Married Engaged Divorced Remarried Separated Father's Name: _________________________________________________ Address (if different than yours)_____________________________________ City ___________________ Prov/State ______ Zip/Postal Code__________ Phone ____________________ Mother's Name: _________________________________________________ Address (if different than father) ____________________________________ City ___________________ Prov/State ______ Zip/Postal Code__________ Phone ____________________ Name of spouse (if married) ____________________________ Children's names and ages: __________________________________________ ______________________________________________________________________ Church Affiliation: ___________________________________________________ Year of your baptism: _________ Where? ________________________________ The congregation you currently attend: __________________________________ Name of an elder or preacher: ___________________________________________
How long have you attended this congregation: _____________________________ To whom will you be giving your Reference Forms? Personal ________________________________ Academic _______________________________ ENROLLMENT INFORMATION Application for: Full year 20___ Fall 20___ Winter 20___ Classification: (check all that apply) Degree Program Full-time studies Part-time studies Transferring credits from other school Are you a mature student who has not graduated from a high school? Yes No List the high schools, colleges, and universities attended (start with most recent): Name ___________________________________________________ Address _________________________________________________ Dates attended ___________________________ Graduation Date ____________ Name ____________________________________________________ Address __________________________________________________ Dates attended ___________________________ Graduation Date ___________ Please attach list of additional institutions to this form. Has a high school, college or university dismissed you for any reason? Yes No If Yes, Explain ______________________________________________________________________ ______________________________________________________________________ Have you been convicted of any crimes other than minor traffic violations? Yes No If Yes, Explain
List school and/or other activities in which you are involved: Page 2 of 3
List awards and honours you have received:
Will you apply for financial assistance from: your local congregation?
Yes No
Government Assistance (OSAP)?
Yes No
PERSONAL STATEMENT Please state briefly why you are interested in enrolling at Great Lakes Bible College:
To the best of my knowledge the information I have given in this application is complete and true. As a student, I will seek to uphold the teachings of Jesus Christ and support the ideals and standards of Great Lakes Bible College. Applicant's signature: __________________________________________ Date ____________ Please return this application with a $50 registration fee Attn: Academic Dean Great Lakes Bible College 470 Glenelm Crescent Waterloo, ON N2L 5C8 Please complete Part 1 of the Academic Reference and Personal Reference forms and send or give them to the appropriate persons in stamped envelopes with the above address on them. Please ask the most recent high school and all post-secondary schools you have attended to forward transcripts to us.
Page 3 of 3
Application for Admission (R-16) Name
Date
PERSONAL INFORMATION Present Address __________________________________________________________ City _______________________ Prov/State _______ Zip/Postal Code______________ Phone _____________________ E-mail _______________________________________ Permanent Address (if different) _____________________________________________ City _______________________ Prov/State _______ Zip/Postal Code______________ Date of Birth ________________ Male Female Birthplace: Country ________________ Citizenship _____________________ Marital Status: Single Married Engaged Divorced Remarried Separated Father's Name: _________________________________________________ Address (if different than yours)_____________________________________ City ___________________ Prov/State ______ Zip/Postal Code__________ Phone ____________________ Mother's Name: _________________________________________________ Address (if different than father) ____________________________________ City ___________________ Prov/State ______ Zip/Postal Code__________ Phone ____________________ Name of spouse (if married) ____________________________ Children's names and ages: __________________________________________ ______________________________________________________________________ Church Affiliation: ___________________________________________________ Year of your baptism: _________ Where? ________________________________ The congregation you currently attend: __________________________________ Name of an elder or preacher: ___________________________________________
How long have you attended this congregation: _____________________________ To whom will you be giving your Reference Forms? Personal ________________________________ Academic _______________________________ ENROLLMENT INFORMATION Application for: Full year 20___ Fall 20___ Winter 20___ Classification: (check all that apply) Degree Program Full-time studies Part-time studies Transferring credits from other school Are you a mature student who has not graduated from a high school? Yes No List the high schools, colleges, and universities attended (start with most recent): Name ___________________________________________________ Address _________________________________________________ Dates attended ___________________________ Graduation Date ____________ Name ____________________________________________________ Address __________________________________________________ Dates attended ___________________________ Graduation Date ___________ Please attach list of additional institutions to this form. Has a high school, college or university dismissed you for any reason? Yes No If Yes, Explain ______________________________________________________________________ ______________________________________________________________________ Have you been convicted of any crimes other than minor traffic violations? Yes No If Yes, Explain
List school and/or other activities in which you are involved: Page 2 of 3
List awards and honours you have received:
Will you apply for financial assistance from: your local congregation?
Yes No
Government Assistance (OSAP)?
Yes No
PERSONAL STATEMENT Please state briefly why you are interested in enrolling at Great Lakes Bible College:
To the best of my knowledge the information I have given in this application is complete and true. As a student, I will seek to uphold the teachings of Jesus Christ and support the ideals and standards of Great Lakes Bible College. Applicant's signature: __________________________________________ Date ____________ Please return this application with a $50 registration fee Attn: Academic Dean Great Lakes Bible College 470 Glenelm Crescent Waterloo, ON N2L 5C8 Please complete Part 1 of the Academic Reference and Personal Reference forms and send or give them to the appropriate persons in stamped envelopes with the above address on them. Please ask the most recent high school and all post-secondary schools you have attended to forward transcripts to us.
Page 3 of 3
