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*

SingleMarriedDivorcedWidow
Mobile Number
Phone Number
Work Number
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?**

New StudentFirst year StudentSecond YearThird 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?**

YesNo
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.*

Yes
Your Signature

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Lamp for the Nations Student Enrollment Form