Harvest Christian University Registration form English

Harvest Christian University

New York - Rockland County
Admission Form

384 New Hempstead Rd., New City, NY 10956
Name*

First NameMiddle NameLast Name
Date of Birth*

MonthDayYear
Month/Day/Year
Place of Birth*
Country
Marriage Status*

SingleMarriedSeparatedDivorcedWidowCo-Habitating
Cell Number*

Country CodeArea CodeCell Number
Email*
Address*

Street

Street 2

CityState

ZipCountry
Degree*

Associates English or Spanish ($106 Mensual)Bachelors Spanish Only ($106 Mensual)Masters Spanish Only ($125 Mensual)Doctoric Spanish Only ($150 Mensu
Years you've served the Lord:*
Date of Adult Baptism (not baby):*
Church you currently attend:
Full Name of Church
City and State of church location:
City, State
Denomination of church:
For example, pentecostal, baptist, Catholic
Do you currently serve at your church?:
For example, musician, greeter, teacher
Give a brief statement as to why you want to study:
Do you currently serve in any Ministry:

SiNo
Which one?:
Highest grade graduated from:

High SchoolCollegeTechnicalGraduate SchoolOther
Occupation:
Note

Whatever the rules and regulations of the school that should be followed by the user
Upload a current photo:

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Take a Photo:
Please verify you are human:*
Student Signature:
Date of Signature:*

MonthDayYear
mm/dd/yyyy
School Location

384 New Hempstead Rd., New City, NY 10956 • 845.482.6071 • maddie@gracepointgospel.org
Should be Empty:

Harvest Christian University