Hosanna Bible College Durham, North Carolina 27707, U.S.A.

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1 , U.S.A. APPLICATION OF ADMISSION Circle the Semester you wish to enter: Fall 20 Spring 20 Summer 20 A non-refundable application fee of $25.00 is due with submission of application for the Undergraduate Program. A non-refundable application fee of $35.00 is due with submission of application for the Graduate Program. Application fees may be paid via VISA, MasterCard, money order, or certified check. The application fee must be received before your application will be processed. Social Security Number Name ( ) Last Maiden First Middle Sex Race (optional) Home Address Street City State ZIP County Birthdate / / Age Birthplace Citizenship Country Home Phone ( ) Work ( ) Address Full Time Part Time On Campus Online Please place an X by the proper response. Are you interested in financial aid programs? Yes No Planned Major or Program High School address Graduation Date GED Date Reason for applying to Program: Name and Address of GED Test Center Continuing Education (Cont ED) Associate in Christian Education Bachelor of Ministry in Modern Music Ministry Bachelor of Theology FAMILY DATA Full Name (If deceased, write deceased after name Occupation Education Level Current mailing address Father Guardian High School attended Master of Christian Education (M.C.E.) Master of Christian Counseling Master of Divinity (M.Div.) Doctor of Ministry (D.Min.) Doctor of Leadership Mother Guardian Husband Wife THIS APPLICATION CONTINUES ON THE BACK

2 TRANSFER APPLICANTS ONLY College/University Location List all post-secondary schools and colleges attended, including summer sessions, correspondence, and extension work. Attach a second sheet if necessary. Date of Attendance Number Degree From To of Hours You must submit an academic transcript from all colleges attended. If less than 12 hours were taken, a high school transcript is also required. Were you ever placed on: Academic Probation? Yes No Academic Suspension? Yes No SPIRITUAL AUTOBIOGRAPHY The Spiritual Autobiography is an important part of the admission s process of. It is a statement of the student s salvation experience, growth in character as a believer in Christ, call to the ministry, current ministry for the Lord, and intended use of a degree from. The institution places a great deal of significance on this document, written in the words of the prospective student. Expectations: The Spiritual Autobiography must be typed. Each major area must have a header above it. Each major area must be at least a paragraph in length. The major areas of the Spiritual Autobiography are: Salvation Experience Growth in Christian Character Call to Ministry Current Ministry Intended use of a degree from The undersigned agrees that the information furnished on this application is complete and correct and that any deliberate omission or falsification of information may result in denial of admission or dismissal. Applicant s Signature Date

3 PROGRAMS OF STUDY Continuing Education (C.E.U.) Undergraduate Programs Associate in Christian Education Associate of Deaf Studies Bachelor of Ministry in Modern Music Ministry Bachelor of Theology Graduate Programs Master of Christian Education (M.C.E.) Master of Christian Counseling Master of Divinity (M.Div.) Doctor of Leadership Doctor of Ministry (D.Min.) admits all academically-qualified students to the rights, privileges, programs, and activities generally available to students at the school. Hosanna Bible College does not discriminate on the basis of age, race, color, national origin, sex, or religion in administration of its educational policies and programs of admissions, financial aid, instruction, employment, athletics, and other collegeadministered programs. PLEASE RETURN COMPLETED APPLICATION, SPIRITUAL AUTOBIOGRAPHY, AND APPLICATION FEE TO: Admissions Dept. Phone: (919) FAX: (888) FOR OFFICE USE ONLY STUDENT ID/CONFIRMATION CODE ASSIGNED: ASSIGNED BY:

4 , U.S.A. We are considering the application of Your name has been given as a reference. STUDENT REFERENCE FORM Name of Applicant for entrance into. INSTRUCTION: Please answer the following questions regarding the applicant as frankly and fully as possible. If you have no basis for judgment, please disregard the item or question. Your reply will be held in the strictest confidence. 1. How long have you known the applicant? 2. What is your relationship to the applicant? 3. Is there any question about the applicant s character? 4. In your opinion, does the applicant have any personal habits which would hinder effective ministry? Yes No If so, please explain. 5. In what phase of ministry is the applicant currently engaged? Please circle the statement which most correctly characterizes the applicant. JUDGMENT Uses poor judgment Misinterprets situations and people Actions usually passive in nature Actions usually well-grounded Judgment considered and respected by others CHARACTER Unbecoming in nature Characterized by immaturity Somewhat passive Increasing in maturity High degree of maturity; Respected CHRISTIAN COMMITMENT Displays little or no commitment Moderately committed Seems to be developing a deeper sense of commitment Highly committed Inspires others to a higher commitment LEADERSHIP Shuns responsibilities Prefers the plans of others Will take responsibilities if asked; Leads in minor affairs Often displays initiative Seeks places of service; Accepted by others as a genuine leader Can you, in good conscience, recommend this applicant for admission into? Yes No Thank you for your prompt attention to our request. Date: Signature: Phone: Printed Name: Address: Please mail this statement to: Office of Admissions Position and Title: City, State, and ZIP

5 , U.S.A. We are considering the application of Your name has been given as a reference. STUDENT REFERENCE FORM Name of Applicant for entrance into. INSTRUCTION: Please answer the following questions regarding the applicant as frankly and fully as possible. If you have no basis for judgment, please disregard the item or question. Your reply will be held in the strictest confidence. 1. How long have you known the applicant? 2. What is your relationship to the applicant? 3. Is there any question about the applicant s character? 4. In your opinion, does the applicant have any personal habits which would hinder effective ministry? Yes No If so, please explain. 5. In what phase of ministry is the applicant currently engaged? Please circle the statement which most correctly characterizes the applicant. JUDGMENT Uses poor judgment Misinterprets situations and people Actions usually passive in nature Actions usually well-grounded Judgment considered and respected by others CHARACTER Unbecoming in nature Characterized by immaturity Somewhat passive Increasing in maturity High degree of maturity; Respected CHRISTIAN COMMITMENT Displays little or no commitment Moderately committed Seems to be developing a deeper sense of commitment Highly committed Inspires others to a higher commitment LEADERSHIP Shuns responsibilities Prefers the plans of others Will take responsibilities if asked; Leads in minor affairs Often displays initiative Seeks places of service; Accepted by others as a genuine leader Can you, in good conscience, recommend this applicant for admission into? Yes No Thank you for your prompt attention to our request. Date: Signature: Phone: Printed Name: Address: Please mail this statement to: Admissions Position and Title: City, State, and ZIP

6 , U.S.A. This form MUST be completed. Information you provide will be used as an aid to providing necessary care while you are a student at Hosanna Bible College. The form will not affect admission decisions but must be filled out completely before you are allowed to register. This information is strictly for the use of and will not be released to anyone without your knowledge or written consent. All medical interactions with our service are held in the strictest confidence. Social Security Number Please Print MEDICAL HISTORY FORM Name: ( ) Last Maiden First Middle Home Address: Home Phone: ( ) Street City State ZIP County Class you are entering (Circle) FR SOPH JR SR Were you previously enrolled here? Y/N If so, dates? Proposed Registration Date Fall Spring Summer Personal Physician: Emergency Contact Name: Telephone Number: Relationship: Phone: ( ) (Home/Work/Cell) Phone: ( ) (Home/Work/Cell) If you are under 18 years of age, have a parent or guardian sign below. Date: Parent/Guardian Signature: Circle any of the following that you have or have had. Give dates and appropriate details. Allergies Drug Addiction Headache (Migraine) Asthma (respiratory ailments) Hypertension Diabetes Epilepsy Typhoid Dizziness Tuberculosis Emotional/Nervous Disturbances Drug Allergies (Please list.) Do you have any other physical/emotional conditions that require a physician s attention? Yes No If so, please explain. NOTE: THIS MEDICAL HISTORY FORM IS CONTINUED ON THE BACK

7 IMMUNIZATIONS REQUIRED FOR ADMISSION North Carolina state law requires that all new undergraduate students have certain immunizations. Immunization records must be kept on file at the college. Students are required to present proof of immunization. Students in North Carolina may obtain copies of their immunization records from their high school. If they meet the minimum requirements of North Carolina law for students in grades K-12, they are acceptable for college entrance. A. Students 17 years of age and younger B. Students born in 1957 or later and are 18 years of age or older C. Students born prior to 1957 Required: 3D TP (Diphtheria, Tetanus, Pertussis) or TD (Tetanus, Diphtheria) dose TD must have been administered within the last ten (10) years 3 Polio (oral) doses 2 Measles (Rubella) doses, on or after the first birthday* 1 Mumps 1 Rubella Dose** Required: 3D TP (Diphtheria, Tetanus, Pertussis) or TD (Tetanus, Diphtheria) dose TD must have been administered within the last ten (10) years 2 Measles (Rubella) doses, on or after the first birthday* 1 Rubella Dose** Required: 3D TP (Diphtheria, Tetanus, Pertussis) or TD (Tetanus, Diphtheria) dose TD must have been administered within the last ten (10) years 1 Rubella Dose** *History of physician-diagnosed measles is acceptable. **Physician-diagnosed rubella is not acceptable. Only laboratory proof of immunity to rubella is acceptable. *** Rubella immunization is not required for students 50 years of age or older. MEDICAL HISTORY This information is strictly for the use of and will not be released to anyone without your knowledge or written consent. Information you provide will be used as an aid to providing necessary care while you are a student. It will in no way affect an admission decision. Please use an extra sheet of paper, if necessary. 1. List all chronic problems requiring current and ongoing treatment. 2. List all medications you use regularly. 3. List all drug allergies. 4. Do you have a psychological or psychiatric problem that has required treatment or therapy within the past two (2) years? Yes No If yes, please explain in detail. (Use an extra sheet of paper.) 5. List all restrictions of physical activity ever recommended to you. 6. Were you ever excused from Physical Education in your former school? Yes No 7. Do you require a special diet? Yes No If yes, please explain. STUDENT STATEMENT: I attest that this medical history is true and complete to the best of my knowledge. Date: Signature: HOSANNA BIBLE COLLEGE Phone: (919) Fax: (919)

8 , U.S.A. STUDENT TRANSCRIPT RELEASE FORM It is your responsibility to have a copy of your transcript forwarded to us from each school you have attended, including high school. If you are currently a high school senior, you must have a transcript forwarded to us now and a final copy forwarded to us upon graduation. If you are currently attending college, you must have a transcript forwarded to us now and a final copy forwarded to us upon graduation or completion of the semester. I have applied for the submit an official copy of my transcript to the following address: program at. Please I hereby authorize. (Name of school/college) to release a transcript (or GED scores) to Name: Address: (Name used while attending school) Date of Birth: Phone Number: ( ) City: State: ZIP: Signature of Applicant: Date of Signature: Reminder: Contact your former college(s) to determine their transcript fee. Then, mail or present this form and transcript fee to any colleges you have attended.

9 , U.S.A. STUDENT TRANSCRIPT RELEASE FORM It is your responsibility to have a copy of your transcript forwarded to us from each school you have attended, including high school. If you are currently a high school senior, you must have a transcript forwarded to us now and a final copy forwarded to us upon graduation. If you are currently attending college, you must have a transcript forwarded to us now and a final copy forwarded to us upon graduation or completion of the semester. I have applied for the submit an official copy of my transcript to the following address: program at. Please I hereby authorize. (Name of school/college) to release a transcript (or GED scores) to Name: Address: (Name used while attending school) Date of Birth: Phone Number: ( ) City: State: ZIP: Signature of Applicant: Date of Signature: Reminder: Contact your former college(s) to determine their transcript fee. Then, mail or present this form and transcript fee to any colleges you have attended.

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