The Potter's House Seminary and Bible College APPLICATION FOR ...
The Potter’s House Seminary and Bible College APPLICATION FOR ADMISSION All questions must be completed in order for your application to be considered for acceptance.
Full Legal Name Last
First
Date of Application
Full Middle Name
(Maiden)
Anticipated Start Date
Home Address Street
City
Phone Number
Cell Number
Email Address U.S. Citizen? (Please circle one): Yes Date of Birth
State
Driver’s License Number with State No
If “no”, Alien Registration Number: A- Age
Social Security Number
Emergency Contact: _______________________________________Phone:
High School Attended/Attending If you have a GED, please note GED Program and date received:
Year of Graduation
Zip Code
City
State
Zip Code
List Colleges you have previously attended: College Address Date(s) Attended
College_________________________________ Address:________________________________ Date(s) Attended:_________________________
Are you currently: licensed, ordained, or a Christian Counselor? (Circle all that apply) What type of degree are you seeking first? (Associate of Arts, Bachelor of Arts, Master of Theology Doctor of Theology (Circle one). What major are you seeking? (Biblical Studies, Christian Counseling, Pastoral Studies, or Prayer and Worship? (Circle One) When do you plan to start (Circle One): 1st QTR, 2nd QTR, 3rd QTR, or 4th QTR? How did you hear about PHSBC? _____________________________________
I hereby certify the information included on this application for admission is true and correct to the best of my knowledge. An official school catalog will be issued to me prior to my enrollment to Potter’s House Seminary and Bible College, or may be viewed at www.pottershouseseminarybiblecollege.com. Application to PHSBC does not guarantee acceptance. Student Signature
Date
ADDITIONAL ITEMS NEEDED FOR APPLICATION The following items must be sent with this application. You will NOT be considered for admission if the below items are not enclosed with application. 1. 2. 3. 4. 5.
High School transcript or GED completion diploma College Transcript Letter of Reference from your pastor or ministry leader. A brief written testimony of your salvation experience. $25.00 non-refundable Application Fee. Mail Application to:
Potter’s House Seminary & Bible College 4801 Gum Branch Rd Jacksonville, N. C. 28540
Full Legal Name Last
First
Date of Application
Full Middle Name
(Maiden)
Anticipated Start Date
Home Address Street
City
Phone Number
Cell Number
Email Address U.S. Citizen? (Please circle one): Yes Date of Birth
State
Driver’s License Number with State No
If “no”, Alien Registration Number: A- Age
Social Security Number
Emergency Contact: _______________________________________Phone:
High School Attended/Attending If you have a GED, please note GED Program and date received:
Year of Graduation
Zip Code
City
State
Zip Code
List Colleges you have previously attended: College Address Date(s) Attended
College_________________________________ Address:________________________________ Date(s) Attended:_________________________
Are you currently: licensed, ordained, or a Christian Counselor? (Circle all that apply) What type of degree are you seeking first? (Associate of Arts, Bachelor of Arts, Master of Theology Doctor of Theology (Circle one). What major are you seeking? (Biblical Studies, Christian Counseling, Pastoral Studies, or Prayer and Worship? (Circle One) When do you plan to start (Circle One): 1st QTR, 2nd QTR, 3rd QTR, or 4th QTR? How did you hear about PHSBC? _____________________________________
I hereby certify the information included on this application for admission is true and correct to the best of my knowledge. An official school catalog will be issued to me prior to my enrollment to Potter’s House Seminary and Bible College, or may be viewed at www.pottershouseseminarybiblecollege.com. Application to PHSBC does not guarantee acceptance. Student Signature
Date
ADDITIONAL ITEMS NEEDED FOR APPLICATION The following items must be sent with this application. You will NOT be considered for admission if the below items are not enclosed with application. 1. 2. 3. 4. 5.
High School transcript or GED completion diploma College Transcript Letter of Reference from your pastor or ministry leader. A brief written testimony of your salvation experience. $25.00 non-refundable Application Fee. Mail Application to:
Potter’s House Seminary & Bible College 4801 Gum Branch Rd Jacksonville, N. C. 28540
