FIA_Student

APPLICATION
STUDENT NAME
FAITH IN ACTION BIBLE COLLEGE
INSTRUCTIONS FOR APPLICATION COMPLETION:
1. Answer all questions completely. If a question does not apply, please answer with "not applicable" or

2. Request Official Transcript from each college, university or institute of ministry that you have previously attended. Note: Official sealed transcripts must be mailed directly from the university to the FIABC admissions office.

3.If college transcripts will not be provided, submit one of the following proofs of high school graduation: Diploma, G. E. D. equivalent. Note: Proof of high school is not necessary for Certificate only (non-credit) students.

4. An application fee of $100.00 to Faith In Action (FIA) with the completed application must be submitted to the FIABC admissions office.
Name

FIRST NAMELAST NAME
MI
MAIDEN NAME IF APPLICABLE
MAILING ADDRESS
CITY
STATE/PROVINCE
ZIP CODE
PHYSICAL ADDRESS

Street Address Line 2

CITYSTATE ZIP CODE

Postal / Zip Code
HOME AREA CODE & PHONE NUMBER
Please enter a valid phone number.
WORK AREA CODE & PHONE NUMBER
Please enter a valid phone number.
CELL AREA CODE & PHONE NUMBER
Please enter a valid phone number.
ALTERNATE CONTACT NUMBER
Please enter a valid phone number.
BIRTHDATE MMDDYYYY

MonthDayYear
Date
PLACE OF BIRTH
SEX
MARITAL STATUS INFORMATION
U.S. CITIZEN
IF NO WHAT COUNTRY
RACE
SOCIAL SECURITY NUMBER
EMAIL ADDRESS
example@example.com
CHURCH BACKGROUND / DENOMINATION
CHURCH PRESENTLY ATTENDING (INCLUDE CHURCH LOCATION)
CHURCH PHONE
PASTOR’S NAME
EMERGENCY CONTACT OTHER THAN SPOUSE
Phone Number
Please enter a valid phone number.
ll. MARITAL STATUS INFORMATION
lll. SPOUSE/FIANCEE INFORMATION
Name

FIRST NAMELAST NAME
MI
IV. DEPENDENT INFORMATION
V. MINISTRY AND EDUCATIONAL GOALS
1. What degree program are you interested in completing at FIABC and why?
2. Briefly state your ministry goals (include short-term and long-term goals.)
3. Please list or describe your experience in serving or ministry.
Vl. PERSONAL TESTIMONY
Please share your personal story and describe your salvation experience with information such as the place and the date of your conversion.
Vll. EDUCATION HISTORY
HAVE YOU PREVIOUSLY ATTENDED BIBLE COLLEGE
HIGH SCHOOL NAME
START DATE (MM/YYYY)
STOP DATE (MM/YYYY)
STUDY EMPHASIS
DID YOU GRADUATE
COLLEGE/UNIVERSITY NAME
START DATE (MM/YYYY)
STOP DATE (MM/YYYY)
MAJOR
DIPLOMA/ DEGREE EARNED
ALL EDUCATION BACKGROUND INFORMATION MUST BE SUPPORTED BY THE FOLLOWING DOCUMENTATION:
** List schools including Bible Institutes, Bible Colleges, other Colleges or Universities. Must have original, sealed, official transcripts sent directly to our local campus. *If you have not attended college: Must send a copy of your high school transcript, diploma, or G.E.D. Note: It is the Applicant's responsibility to request, pay for, and follow-up on all Transcripts requested.
Vlll. PERSONAL HEALTH STATUS
HEIGHT
WEIGHT
YOUR GENERAL HEALTH
Briefly descried your health history or current conditions as relates to the ability to complete our course of study:
Please list all current medications and the dosage of each in case emergency care is needed:
MEDICAL CONSENT
I hereby grant permission to Faith In Action Bible College, to render me to any emergency treatment, medical or surgical care that might be deemed necessary. Also, when necessary for executing such care, I grant permission for hospitalization at an accredited hospital at no expense to FIABC.
Student Name print
Student Name signature

Clear
Date

MonthDayYear
Date
Non-Discrimination Policy The Faith In Action Bible College does not discriminate on the basis of nationality, ethnic origin, age, or gender. We guarantee the rights and privileges, and the availability of programs and activities to all students of the college.

Privacy Rights of Students STATUTE 20, UNITED STATES CODE, 1232g and regulations adopted pursuant thereto, hereinafter referred to as the Code, requires that each student be noti- fied of the rights accorded him or her by the Code. The following is provided as basic general information relative to the CODE: The Code provides for an institution to establish a category of student information termed "directory information." When available in college records, any infor- mation falling in the category of "directory information" will be available to all persons on request (i.e., the IRS, FBI, or other government agencies, and for use in FIABC publications FIABC has identified the following student data as "Directory Information:"

1. Name 2. Address 3.Telephone Listing 4. Race 5.Date & Place of Birth 6.Major Field of Study 7.Church Membership 8.Dates of Attendance 9.Degrees & Awards Received 10. Educationsl Institution Attended

All other information, such as social security numbers, health and medical records, disciplinary records, records of personal counseling, required student and family financial income records, transcripts or student permanent academic records, student placement records and other personally identifiable information shall be open for inspection only to the student and such members of the professional staff of the college as have responsibility for working with the student. Such information will not be released to second parties without consent of the student. Except as required for use by the president in the discharge of his official responsibilities as prescribed by laws, regulations of the state board, and board policies, the designated custodian of such records may release information form these records to others only upon written authorization from the student or upon a subpoena by a court

PLEASE READ CAREFULLY THE AFFIDAVIT OF AGREEMENT BEFORE SIGNING.

1. I certify that I have truthfully and accurately answered all questions contained in this application. I understand that falsification of any kind is grounds for refusal of admission should falsehood be discovered after acceptance to the college and expulsion may be necessary. 2. I indicate by my signature that I have been notified of my rights as recorded by Statute 20, United States Code, 1232g. 3. I certify by my signature that I agree to abide by the policies of FIABC as described in the Faith In Action Bible College official Student
STUDENT SIGNATURE

Clear
DATE

MonthDayYear
Date
Student Application Checklist:
Completed Application Proof of High School Diploma or GED Official Transcripts requested Application Fee of $100.00

Faith In Action Bible College P.O. Box 2187 Foley, AL 36536 **Official College Transcripts may also be mailed to the address above. **
Attach Recent Photo Here
Transcripts

Cancelof
Should be Empty:

APPLICATION

FAITH IN ACTION BIBLE COLLEGE

INSTRUCTIONS FOR APPLICATION COMPLETION:

ll. MARITAL STATUS INFORMATION

lll. SPOUSE/FIANCEE INFORMATION

IV. DEPENDENT INFORMATION

V. MINISTRY AND EDUCATIONAL GOALS

Vl. PERSONAL TESTIMONY

Vll. EDUCATION HISTORY

ALL EDUCATION BACKGROUND INFORMATION MUST BE SUPPORTED BY THE FOLLOWING DOCUMENTATION:

Vlll. PERSONAL HEALTH STATUS

MEDICAL CONSENT

Student Application Checklist: