Biblically Based Counseling and Training
 

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Enrollment Form

General Information
Select a program * Please select the program that you are interested in.
First Name *
Last Name *
email *
Billing Address
City
State
Zip Please put your mailing address here if it is different from your billing address
Mailing address
City
State
Zip
Home Phone #
Cell Phone
Work Phone #
Social Security #
Date of Birth
Gender
Graduated high school in;
Have you ever been convicted of a felony? If yes, please explain in detail including dates
Current Occupation

College Information
I graduated college in;
Highest degree & Major
Name of college
Graduate or Professional school Please list school name, date graduated and degree confered

Spiritual Information
I've been a Christian for; Please tell us how long you have been a Christian
Clergy Status
Date clergy status confered
denomination preference

Additional Information
Please answer the following questions
Why do you want to be a counselor? Please explain why you feel called to the Ministry of Counseling
What formal / informal training Please explain what formal or informal training you have had in the area of Counseling.
Program Benifits Please explain why you believe this program will be a value to you
Experience Please list your experience in dealing with people with spiritual or emotional problems
What our your goals? Please tell us what your goals are for the Counseling Ministry
Are you called? How do you know that you are called / suited for the Counseling Ministry
Submit Application
Please note that there will be additional information and requirements to complete each program
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