Intrest & Information Form
Below is an inquiry form for the AKSM. This is not an application, but a form that gives us more information about you, so we can have a better understanding of who you are as we help you decide if AKSM and Aidan University are the right fit for you. There is no obligation in filling out this form, but it is the next step to having a more detailed discussion with Dr. Jim that will help you make your decision.
General Information
We promise not to use any of this information for unwanted contact.
Date
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-
Month
-
Day
Year
Date
Name
*
First Name
Last Name
Gender
Male
Female
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Email (Please confirm your email in the second box)
*
Confirmation Email
example@example.com
Please indicate your age range.
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18-29
30-49
50-69
69 and above
Not interested in sharing this information
Intentions as an AKSM Student
If you had to guess, what level of study would you be most interested in?
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Audit Student
Certificate Student
Associate Degree Student
Bachelor Degree Student
Graduate Degree Student
Post Graduate Degree Student
I am still trying to figure it out. I want to talk about what best fits my situation.
What level of commitment are you contemplating?
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Part-time
Full-time
I am still trying to figure it out. I want to talk about what best fits my lifestyle and finances.
Do you think you are interested in attending classes with a cohort or being a mentored independent study student?
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Live Online Classes with a Cohort
A Mentored Independent Study Student
I am still trying to figure it out.
Education Background
Highest Education Level Completed
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High School
Trade School
Associate Degree
Bachlor Degree
Graduate Degree
Post Graduate Degree
Please list the names of each institution you attended. Next to the institution, degrees, awards, and certificates you earned.
*
Religious Background
We do not have any denominational affiliation and except all people who see themselves as fully devoted disciples of Jesus or desire to grow more deeply in their relationship with Him and other disciples. Your ministry experience in the last box will help us have a better idea of how those experiences may matriculate into actual course credit.
Name of the church you presently attend
*
Number of years you have attended this church
*
Name of the pastor of the church or leader you are in the closest connection
*
Please give us a brief understanding of your ministry experiences in or outside the local church.
*
Life and Work Experience
By share these with us, you will help us have a better idea of what work and life experiences may matriculate into actual course credit.
Please give us a brief description of areas of service you have been involved in (others than those listed above) that may or may not have had a direct religious basis.
*
Please give us a brief description of your work history.
*
Referral
If someone referred you to AKSM, please fill in the following information.
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Submit
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