Agape Seminary
Application for Admission
PO Box 7078
Clearwater, FL. 33758
Full Name: ______________________________________________________
(Last) (First) (Middle)
Address: _____________________________________________________
_____________________________________________________
_____________________________________________________
Age ............ Date of Birth ..................... Married / Single / Divorced? ................
Telephone Number ....................................... E-mail .......................................................
Current occupation?............................................................................................................
Current Church Affiliation? ...............................................................................................
State the Degree program you wish to apply for: ............................................................
Ordination - If interested in preparation for Ordination - check here. ........................
Previous Education:
Name of College, Seminary, Course, etc.
Dates Attended Degree
_______________________________________________________________________
_______________________________________________________________________
Financial Information:
Degree/Program and Fees: ______________________________________
Payment
attached ________ Or, I prefer to make a deposit of ________ and installments of ________
I hereby apply for registration as a student with Agape Seminary. I attest that I am a Christian and accept the guidance of Jesus in my life. I agree to abide by the rules and regulations of the Seminary.
Date: _________ Student Signature: __________________________________