CHRISTIAN

SEMINARY

                                                                       Agape Seminary
                                                               Application for Admission

                                                                         PO Box 23175
                                                                Ottawa, Canada K2A 4E2


Name: __________________________________

Mailing Address:__________________________          City / State: _________________________

 Age:_______    Date of Birth:__________________    Married / Single / Divorced:

 Telephone Number: ____________________________    Email:_________________________________________

 Current occupation:____________________________   Church Membership / Denomination:__________________

 State the Degree program you wish to apply for:______________________________________________________

 Are you interested in Ordination?_________________________

 Previous Post-Secondary Education: (List below)
  Name of Institution:          Dates Attended:          Number of Credits:     Degree:Program:       Did you Graduate?

 ___________________       ________________      ______________         _________________    _______________


 ___________________       ________________      ______________         _________________    _______________


 ___________________       ________________      ______________         _________________    _______________


 ___________________       ________________      ______________         _________________    _______________
 
Financial Information: Please include a deposit of $100 minimum.
Checks to be payable to Agape Seminary

Amount Enclosed _________________   Program Fee: _________________

I hereby apply for registration as a student with Agape Seminary. I attest that I am a Christian and  I agree to abide by the rules and regulations of the Seminary. Please attach any supporting material suitable with your application.


Please sign and date:____________________________________________________________________________


(Please print this page, complete it, and return to the address listed on top)