Address: Type carefully, as this is our preferred mode of communication

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1 APPLICATION FORM OCCA Programme Please fill in the white portion within each section 1 First Name(s): BLOCK CAPITALS, underline the name you use Family Name (Surname): BLOCK CAPITALS 2 Title/Salutation: Copy and Paste icon if completing form electronically Mr Mrs Ms Miss Dr Revd Other: 3 Current Occupation: 4 Date of Birth: (eg 17-Jan-00) Admission criteria require minimum age of 21 5 Nationality: 6 Permanent Address: Telephone Number: Fax Number: Address: Type carefully, as this is our preferred mode of communication Skype Address: 7 Proposed year of entry: 8 Are you an MTh candidate? Please circle relevant response 9 YES / NO How did you hear about the course? 1

2 10 Marital Status & Family: Single Engaged Married Widowed Divorced Remarried If engaged, give the name of your fiancé and intended date of marriage: If married, give the name of your spouse and date of marriage: If you have children, give their names (and date of birth if under 18): Will you be bringing your family with you to Oxford? If so, please indicate which members of your family you would expect to accompany you: 11 Academic Record: University degree or equivalent: University/Institution Year Degree(s) with classes and subjects Degree(s) with subject and GPA (US) Other higher education: (eg: Doctorate, Masters) University/Institution Year Degree(s) with classes and subjects Degree(s) with subject and GPA (US) Other relevant qualification: School/Institution Year Qualification achieved General Education/pre-university: School/Institution Year Qualification achieved 12 Principal Employments Held: Present employment first Dates Employer and Job Title Location 2

3 13 Other Applications: We fully understand that you may be considering other colleges, seminaries and universities. Please state which ones you are currently applying to and whether you have been offered a place at any other college/university. 14 Disability or Special Needs: We welcome students with disabilities and will try to meet your needs wherever we can. Please tell us whether you have a disability, special needs (including dyslexia or another specific learning difficulty) or a medical condition which we need to be aware of. 15 Criminal Record: Have you been convicted of any criminal offence during the past four years? If yes, please state the nature and date(s) of the offence(s). 16 Finance: How will you be paying for your studies? Please check one of the boxes below, and provide full details of how you will be financing your studies and living costs during your time in Oxford. We will need to see copies of letters or appropriate financial statements in support of this. Copy and Paste icon if completing form electronically Public funding Private funds Student loan Other (please specify) I do not have an income and fund my university fees and maintenance with a student loan. I will apply for funding from the Michael Green trust and other relevant trusts in the hope to obtain funding for the course. Please provide further details of how you expect to finance your studies below. 17 Religious Denomination: 18 Places of worship regularly attended over the past 5 years: Present location first 3

4 19 Referees: In order to process your application as quickly as possible, we use to contact referees. Please provide us with the details of ONE referee who can comment on your experience of and passion for sharing Christ with others. This referee should have known you for a minimum of 2 years and must not be a family member. We require the full name of your referee and an active address. Referee name: Referee address: 20 Your Christian background and evangelistic experience: Please describe briefly how you came to be a practising Christian and what your Christian faith means to you now, mentioning any Christian ministry you may have been involved in, particularly in relation to evangelism and apologetics. 4

5 21 Reasons for wishing to undertake this course and how you see it aiding your future calling: Please describe why you are considering coming to study on the OCCA Programme, and what you would hope to gain from your time studying in Oxford. 22 Date application form completed: Check List to be completed before sending form: Fully complete all applicable sections of application form. electronic copy of Application Form to By submitting this completed form, I confirm that the information I have recorded in this application form is, to the best of my knowledge, complete and accurate, and I understand that information provided on this form will be held by the Oxford Centre for Christian Apologetics for the purposes of student administration subject to the provisions of the Data Protection Act. (1998). 5