Application for Status form
Name
*
Mr
Mrs[Miss
Ms
Dr
Rev
Pastor
Fr
Rev Dr
Title
First Name
Last Name
ACD Student Number
*
Email
*
example@example.com
Course for Status to be credited to
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Certificate IV in Christian Ministry & Theology
Undergraduate Certificate of Christian Leadership
Undergraduate Certificate of Ministry Studies
Diploma of Ministry
Associate Degree in Ministry
Bachelor of Ministry
Graduate Certificate in Ministry
Graduate Diploma in Ministry
Master of Ministry
Doctor of Ministry
Specified Status: Number of points requested
*
Un-Specified Status: Number of points requested
*
Total Number of points requested
*
Status details
*
Rows
ACD Unit Code
ACD Unit Name
Other Provider Unit name & Code
Grade
Unit details
Unit details
Unit details
Unit details
Unit details
Unit details
Unit details
Unit details
Academic History. Please complete the details of Qualifications/previous studies relevant to this application.
*
Rows
Previous Institution name
Years (e.g.1991-92)
Full Award Name
Completed Y/N
Details
Details
Details
Details
Details
Details
Details
Please attached a certified copy of required Document. eg Transcripts, Parchments, statements of Attainment
*
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I certify that the information in this form and attached evidence given in support of this application is accurate and complete.
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Date
*
-
Day
-
Month
Year
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