Personal Information
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Birth Date
*
-
Month
-
Day
Year
Date
Social Insurance Number
*
Medical Information
Gender
*
Please Select
Male
Female
Health Care Number
Do you have a health care plan?
Yes
No
Describe any medication taken regularly and reason for its use.
Indicate intoxication used in the past 6 months
*
Alcohol
Any form of Cannibas product
Illegal Drugs of any kind
None
Other
Provide an explanation for intoxication
Rate your physical health on a scale of 1-10 and briefly justify your answer.
*
Have you ever had a formal diagnosis of depression, anxiety, or other social emotional challenges. If yes, please explain.
*
Have you ever been subject to psychological or psychiatric care?
*
Please Select
Yes
No
Other
Please check the box to say that you give permission for medical consent. I hereby grant permission to Home Church College or its consulting physician to render to me any emergency treatment, medical or surgical care that may be deemed necessary. When such care is required, I grant permission for hospitalization at an accredited hospital. (If the applicant is under age 18, guardian signature is required - please send a note by fax 403-343-8480)
*
Please Select
Yes
No
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Applying info
Course of Interest
Certificate of Christian Ministry (1yr program)
Diploma of Christian Ministry (2yr program)
Bachelor of Theology & Practical Ministry (3yr program)
Part-Time/Audit
Applying for
Fall Semester 2023
Winter Semester 2024
Fall/Winter 2023/24
Did someone refer you to our program?
What is their contact info? Phone/Email
What do you feel like you are meant to do on this planet before you leave it? This may be a hard one for you; don't over think it, be as honest as you can. (if you don't know, you don't know)
Please indicate any hobbies, interests or talents
Educational History
Indicate which schools you have previously attended. Include name of High School and any Colleges you have attended.
Do you have any learning disabilities, such as dyslexia or test anxiety that could effect you in Bible College. If yes, please describe below.
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Your Christian experience
Mark all that you have personally experienced.
Born again according to John 3:3
Baptized by immersion according to Mark 16:16
Received the baptism of the Holy Spirit according to Acts 2:4
Attend church on a regular basis
Your Story
What is the name of the church are you a part of. Where is it located? How long have you been a part of this church? How are you involved?
Pastor's Full Name
First Name
Last Name
Pastor's Email
example@example.com
Pastor's Phone
Please enter a valid phone number.
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I certify that all statements made in connection with this application are true and complete in all respects and that no information has been withheld. I understand that misrepresentation, falsification of documents or withholding of requested information are serious offenses which may result in the cancellation of my admission and registration at Home Church College. I waive any right to view or challenge the information given by any reference to Home Church College. I trust that all information given by references will remain confidential.
Yes
No
Signature
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