Course Registration Form

Lamp for the Nations Student Enrollment Form

Fill out the form carefully for registration
Today's Date Date*
Please upload a recent picture of yourself.

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Student Name

First NameMiddle NameLast Name
Birth Date

MonthDayYear
Gender
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Student E-mail
example@example.com
Please enter your relationship status
Mobile Number
Format: (000) 000-0000.
Phone Number
Format: (000) 000-0000.
Work Number
Format: (000) 000-0000.
Have you attended Lamp for the Nations before? Write Yes or no
When did you attended Lamp for the Nations?
Are You a New Student, First Year, Second Year or Third Year Student?*
How many years of school completed. Please enter the number below.*
Name of school you most RECENTLY graduated from.
Do you have a college degree?*
If Yes what is the name of your degree?
What is God calling you to do in ministry? Example: Pastor, Evangelist or music director etc. Be specific.
Why do you want to attend Lampfor the Nations?
Please upload a Letter of Recommendation from your pastor, teacher or mentor.

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Please upload your Personal Testimony. It must be detailed. When did you accept Christ. Have you been baptized in water. Have you been baptized in the Holy Spirit. Ministry experiences, etc.

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Additional Comments
I AGREE TO FOLLOW THE ZOOM AGREEMENT TO KEEP MY CAMERA ON AT ALL TIMES AS LONG AS POSSIBLE.
Your Signature
Should be Empty:

Lamp for the Nations Student Enrollment Form