BASSM Application
Contact Information
Name
*
FIRST
LAST
Phone number
*
Format: (000) 000-0000.
Email address
*
Address
*
STREET
STREET LINE 2
CITY
STATE / PROVINCE
POSTAL / ZIP CODE
Personal Information
Date of birth
*
-
Month
-
Day
Year
Gender
*
Please Select
Male
Female
Marital status
*
Please Select
Single
Married
Separated
Divorced
Widowed
Spouse's name
*
FIRST
LAST
Will your spouse be attending school?
*
Please Select
Yes
No
Medical Information
Do you have any physical, emotional, and/or mental conditions?
*
Please Select
Yes
No
If yes, Please briefly explain.
Do you require any special attention, treatment, or medication?
*
Please Select
Yes
No
If yes, Please briefly explain.
Do you have any illnesses?
*
Please Select
Yes
No
If yes, Please briefly explain.
Have you received treatment for any physical, emotional, and/or mental condition in the last five years?
*
Please Select
Yes
No
If yes, Please briefly explain.
Do you have any physical, emotional, and/or mental limitations you might experience while attending BASSM
*
Please Select
Yes
No
If yes, Please briefly explain.
Have you exhibited any self-destructive behavior or habitual problems within the last five years
*
Please Select
Yes
No
If yes, Please briefly explain.
Christian Experience
Have you accepted Christ as your personal savior?
*
Please Select
Yes
No
Have you been baptized in the Holy Spirit according to Acts 1:8 and 2:4?
*
Please Select
Yes
No
Do you attend church regularly?
*
Please Select
Yes
No
Church name
*
Pastor's name
*
FIRST
LAST
Have you recently left another church?
*
Please Select
Yes
No
Was it a good parting? Or are there unresolved issues?
*
Please Select
Good parting
Unresolved issues
Life Experience
Have you used tobacco in the last six months?
*
Please Select
Yes
No
If yes, Please briefly explain.
Have you consumed alcohol, in excess, in the last six months?
*
Please Select
Yes
No
If yes, Please briefly explain.
Have you used illegal drugs in the last six months?
*
Please Select
Yes
No
If yes, Please briefly explain.
Have you been involved with pornography in the last six months?
*
Please Select
Yes
No
If yes, Please briefly explain.
Have you been sexually active outside of marriage in the last six months?
*
Please Select
Yes
No
If yes, Please briefly explain.
Have you been involved in homosexuality in the last five years?
*
Please Select
Yes
No
If yes, Please briefly explain.
Have you ever been arrested?
*
Please Select
Yes
No
If yes, Please briefly explain.
Have you ever been convicted of a crime?
*
Please Select
Yes
No
If yes, Please briefly explain.
Have you ever been involved with the occult, witchcraft, or cults?
*
Please Select
Yes
No
If yes, Please briefly explain.
Recommendations
Pastoral recommendation
*
FIRST
NAME
Pastoral recommendation email
*
Pastoral recommendation phone number
*
Format: (000) 000-0000.
Personal recommendation
*
FIRST
LAST
Personal recommendation email
*
Personal recommendation phone number
*
Format: (000) 000-0000.
Briefly explain why you want to attend the Bethel Atlanta Schools of Supernatural Ministry.
*
If sin arises in your life are you ready and willing to address it?
*
Please Select
Yes
No
Are you ready and willing to embrace the process of discipleship and allow yourself to be led?
*
Please Select
Yes
No
Are you ready and willing to disrupt your life and address anything that doesn't look like Jesus?
*
Please Select
Yes
No
Application Fee
*
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BASSM Application Fee
Non-refundable application fee for Bethel Atlanta Schools of Supernatural Ministry
$
50.00
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