Admissions Application Request

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Answer the following questions in your own words. Please note, prolonged inactivity can cause this application to time out. If you need time to consider your answers, please "Save Application & Finish Later".

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First Name
Middle Name
Last Name
Maiden Name
Email Address
Date of Birth
Gender
Citizenship Status
Citizenship Country
Marital Status

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Contact Information
Address Line 1
Address Line 2
City
State
Zip Code
Home Phone # Ext:
Cell Phone # Ext:
Work # Ext:

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Emergency Contact
By signing the below, hereby state that on the date indicated, I do grant full and complete permission to Kenneth Copeland Bible College, its employees or designate, or any related or consulting physician to render or give emergency medical aid, care, treatment, or assistance that could or would be deemed required or necessary. I also state that should hospitalization be required, I grant full and complete permission for such care and treatment. This consent I give freely, fully knowing and understanding all the above and its relation to and effect upon me.
Relationship
First Name
Last Name
General Information
Pastoral Reference

Phone # Ext:
Please click the links below to read each affirmation. Then check each box stating your agreement to each.
Honorable Life Covenant
Standards of Conduct
Statement of Faith
Dress Code
Student Financial Agreement
Active Member of Eagle Mountain International Church
First Personal Reference
Second Personal Reference

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High School Attended
We are excited God is leading you to attend Kenneth Copeland Bible College. Before filling out your application, here are a couple of items you need to know:
• Your session will timeout after 2 hours - if more time is needed, please click "Save and Finish Later" at the bottom of the screen.
• A $100 application fee is required. After submitting your application, you'll be directed through the payment process.
• You will be asked to provide the names and contact information for a pastoral recommendation and two personal recommendations. Please have this information ready before you begin the application process.
• You will be responsible for downloading and distributing the recommendation forms to your provided references. The download link will be provided in your application confirmation email.
Anticipated Starting Year

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How did you hear about KCBC?
Date of Marriage
Check this box if you have been convicted of a misdemeanor / felony criminal offense
I have been convicted of a misdemeanor / felony criminal offense
If yes, explain number of conviction(s), nature of offense(s) leading to conviction(s), how recently such offense(s) was/were committed, sentence(s) imposed, and type(s) of rehabilitation.
Please check the box if you are presently under the care of a physician
I am presently under the care of a physician
If you checked the box above, please explain
Please type your full name and date if you consent to the above statement
Highest Level of Education Completed
Please check the box if you can read, write, and comprehend the English language
I can read, write, and comprehend the English language
How do you plan to finance your education at KCBC?
Please indicate your agreement by checking the boxes:
Honorable Life Covenant

Standards of Conduct

Statement of Faith

Dress Code

Student Financial Agreement

Active Member of Eagle Mountain International Church
First Name
Last Name
Phone
Address Line 1
Address Line 2
Email
City
State
Zip Code
First Name
Last Name
Phone
Email
Address Line 1
Address Line 2
City
State
Zip Code
Dependent 1 Name
Dependent 1 Age
Dependent 1 Relationship
Dependent 2 Name
Dependent 2 Age
Dependent 2 Relationship
Dependent 3 Name
Dependent 3 Age
Dependent 3 Relationship
(Please note we are not able to accept international students at this time)
School 1 Name
Current Employer
Current Position
Current Employment Start Date
Current Employer End Date
Past Employer 1 Name
Past Employment 1 Position
Past Employment 1 Start Date
Past Employment 1 End Date
Past Employer 2 Name
Past Employment 2 Position
Past Employment 2 Start Date
Past Employment 2 End Date
Work History
School 1 Start Date
School 1 End Date
School 1 Degree Aquired
Education History
School 2 Name
School 2 Start Date
School 2 End Date
School 2 Degree Acquired
School 3 Name
School 3 Start Date
School 3 End Date
School 3 Degree Acquired
Date of Completion
Starting after high school, list the educational institutions you've attended:
Starting with your PRESENT employer, list your past work experience:
Church History
Current Church Name
Address Line 1
Address Line 2
City
State
Zip Code
How long have you attended this church? (Years / Months)
Do you attend church regularly?
Are you a member of your current church?
Are you a tither?
If you have attended your present church less than a year, please list the previous church(es) you've attended:
Previous Church 1 Name
Previous Pastor's Name
Church Past 1 Start
Church Past 1 End
Church Past 2 Name
Church Past 2 Pastor's Name
Church Past 2 Start
Church Past 2 End
Church Past 3 Name
Church Past 3 Pastor's Name
Church Past 3 Start
Church Past 3 End
Church Licensed or Ordained
Church Denomination / Organization
Address Line 1
Address Line 2
City
Email
First Name
Last Name
Phone
State
Zip Code
How long have you known this individual (Years/Months)?
How long have you known this individual (Years/Months)?
How long have you known this individual (Years/Months)?
Current Pastor's Name
Why do you want to attend Kenneth Copeland Bible College?
Write a brief testimony of your Christian experience, including details of your salvation, and any other significant events that have contributed to your Christian growth including water baptism?
Have you received the baptism of the Holy Spirit with the evidence of speaking in tongues? If yes, please briefly describe what this has meant to your Christian growth?
Do you have any dependents you will be responsible for? If so, please list them below.
By submitting this application, I certify that I have truthfully and accurately answered all questions contained in this application. I understand that falsification of any kind is grounds for refusal of my application or expulsion should falsehood be discovered after acceptance into the academic program.

Contact Information

Emergency Contact

General Information

Pastoral Reference

First Personal Reference

Second Personal Reference