Application Form

Semester Applying for *
First Name *
Last Name *
Date of Birth *
Address *
Street Address *
Apt, Suite, Bldg (Optional)
City
State / Province / Region *
Postal / Zip Code *
Country *
Cell Phone *
Email *
Marital Status *
Years in USA / Canada *
Degree(s) , Graduation Year & Institution *
Church Name *
City *
State *
Name of Father of confession *
Role(s) in Church service *
Duration of Church Service *
Please explain how spiritiuality affects family ministry or counseling *
What is your definition of counseling? *
Please list any lectures/conferences you have attended or books that you have read that pertain to counseling *
How do you think that others perceive you? *
Explain briefly how you would address a brother/sister in the church suffers from continuously falling in the same sin *
Why do you want to enroll in this program? *
Give brief biographical history
Describe your strengths/weaknesses *
What are your goals in life? *