Faith Christian University Academic Evaluation

Pre-Assessment And Information Form
Full Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Cell Phone:

Area CodePhone Number
Business
E-mail:
Website:
MINISTRY INFORMATION
Church:
Ministry
Church/Ministry Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number:

Area CodePhone Number
Fax Number:

Area CodePhone Number
E-mail:
Position:

Other
Years:
Member Organization:
Location:
EDUCATIONAL HISTORY
Education:
Degree(s) Awarded:
List Schools Attended:
Desired Degree Goal(s):
Major:
Ministry Goal(s):
EMPLOYMENT INFORMATION
Additional Employment:
Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Position:
How Long:
Interested in FCU's:
Should be Empty: