Florida International F.I.T.S Theological Seminary APPLICATION FOR ADMISSION

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1125 Grant Street West Palm Beach, FL 33407 Fax (561) 557-8973 Website: www.thelifctr.org APPLICATION FOR ADMISSION I hereby request admission to Florida International (); whereby, I may study to show myself approved to God, a workman that need not be ashamed. I submit myself to the Lordship of Jesus Christ, my Lord, and my Savior. I submit this application to Florida International in the witness of God, and in obedience to His call upon my life. I hereby declare I will fulfill His calling upon my life, to complete all studies as directed by the Lord and representatives of, and to enter the harvest fields, a laborer for the GOSPEL MINISTRY of Jesus Christ. STUDENT ID # (School Use Only) PLEASE PRINT LEGIBLY DATE OF APPLICATION: SOCIAL SECURITY NUMBER: HOME PHONE NUMBER: ( ) CELL PHONE NUMBER: ( ) DATE OF BIRTH: MALE: FEMALE: NAME OF APPLICANT: (Last) (First) (MI) HOME ADDRESS: CITY: STATE: ZIP: EMAIL ADDRESS: Your acceptance package will be emailed to you. PLEASE ENCLOSE A RECENT PHOTO AND A $50.00 APPLICATION FEE.

PLEASE SELECT DESIRED DEGREE AND AREA OF STUDY Degree Programs Master of Ministry Doctor of Ministry Master of Ministry in Biblical Studies Doctor of Ministry in Biblical Studies Masters of Ministry in Christian Counseling Doctor of Ministry in Christian Counseling Masters of Ministry in Christian Education Doctor of Ministry in Christian Education Masters of Ministry in Divinity Doctor of Ministry in Divinity Masters of Ministry in Urban Ministry Doctor of Ministry in Urban Ministry Masters of Ministry in Theology Doctor of Ministry in Theology

VOCATION & WORKING HISTORY Please list your vocational and work history beginning with your most recent first. 1. EMPLOYER S NAME: 2. EMPLOYER S NAME: 3. EMPLOYER S NAME: 4. EMPLOYER S NAME:

EDUCATION HISTORY: Please list your educational history, starting with the high school attended, then any vocational, college, university, Bible College, or Seminary studies completed. If you did not graduate from high school, please list the number of credits that you completed. If you did not graduate from any of the colleges listed, please list the number of Credit hours completed for each college listed. Please do not list any educational history that you are unable to provide OFFICIAL DOCUMENTATION FOR! Name of School City and State Years Attended ( - ) Diploma, Degree Units/Credits Earned Area of Study SEMINAR & CEU HISTORY: Please list any documented Seminars, Workshops, Study Courses, or Continuing Education Programs you may have attended starting with the most recent first, then going back use additional paper if necessary. Name of Seminar/Training City and State Dates Attended ( - ) Certificate Earned Number of Clock Hours MILITARY HISTORY: BRANCH OF SERVICE: YEARS OF SERVICE: TOTAL YEARS SERVED: COMMISSION UPON DISCHARGE: STATUS OF DISCHARGE: POSITION & DUTIES:

CHURCH HISTORY: Please complete the following information listed below regarding your relationship with Jesus Christ, the local church you attend and any positions or responsibilities you may be involved with to support your church (Pastor, Praise and Worship, Teacher, Nursery, Helps, etc.), and any other ministries you may support or be involved with; i.e. missions, evangelism, food banks, etc. Please continue on additional paper if necessary. DATE YOU RECEIVED JESUS CHRIST AS YOUR LORD AND SAVIOR. HAVE YOU BEEN WATER BAPTIZED? DATE: NAME OF THE CHURCH THAT YOU PRESENTLY ATTEND: ADDRESS: PASTOR S NAME: TELEPHONE:( ) YEARS IN ATTENDANCE: POSITION or RESPONSIBILITIES: NAME OF THE CHURCH THAT YOU PREVIOUSLY ATTENDED: ADDRESS: PASTOR S NAME: TELEPHONE:( ) YEARS IN ATTENDANCE: POSITION or RESPONSIBILITIES: NAME OF THE CHURCH THAT YOU PRESENTLY ATTEND: ADDRESS: PASTOR S NAME: TELEPHONE:( ) YEARS IN ATTENDANCE: POSITION or RESPONSIBILITIES: I hereby state that all of the information listed on this application is true and accurate as unto the Lord as my witness. I hereby grant permission to Florida International to verify all of the information listed above. I further agree to and understand that any and all Earned Life Credit Hours, Educational Credit Hours, and Ministry Credit Hours based upon this application are granted at the discretion of Florida International. I hereby agree and understand that I will complete all course requirements as unto the Lord Jesus Christ, and I will comply with all Policies and Financial Commitments in pursuit of academic excellence in the Word of God. I hereby further understand that all of the courses and degrees of Florida International are of an ecclesiastical nature and, whether granted or conferred, are in the restricted area of religion with the special purpose of preparing persons to work in the area of religion - whether Educational, Ministerial, or Counseling - and are NOT designed to be used in general academic circles. APPLICANT S SIGNATURE: DATE:

Transcript Request Form PLEASE SEND AN OFFICIAL TRANSCRIPT OF MY RECORDS TO: FLORIDA INTERNATIONAL THEOLOGICAL SEMINARY 1125 GRANT STREET WEST PALM BEACH, FLORIDA 33407 THIS RECORD IS REQUIRED BY SOUTH COLLEGE TO COMPLETE MY ADMISSIONS FILE. LAST NAME FIRST MIDDLE MAIDEN OTHER LAST NAME BIRTH DATE SOCIAL SECURITY NUMBER DATES ATTENDED OR GRADUATION DATE CURRENT STREET ADDRESS TELEPHONE NUMBER CITY STATE ZIP CODE NAME OF HIGH SCHOOL/COLLEGE/SEMINARY ATTENDED OR GRADUATED FROM ADDRESS: (STREET OR POST OFFICE BOX) CITY ZIP CODE STUDENT SIGNATURE DATE NOTE: FAILURE TO SUBMIT PROOF OF HIGH SCHOOL/COLLEGE/ SEMINARY TRANSCRIPTS WILL BLOCK FUTURE REGISTRATION. Please mail this form to the school(s) where your transcripts are located. MAKE COPIES AS NEEDED FOR ALL INSTITUTIONS

Credit Card Payment Student s Printed Name: Card Holder s Printed Name: Credit Card Type: Master Card Visa Other Credit Card Number: Expiration Date: Total Charge Amount: Date of Charge: Billing Zip Code: Authorized Signature: