Application for Enrollment / Evaluation

Please complete all information

Full Name:
Street Address:
City:
State:
Zipcode:
Country:
Home Phone:
Business Phone:
E-mail Address:
Date of Birth:
Place of Birth (city, state):
Total Years in Ministry:
Present Occupation:
How long?
Social Security Number:
Sex:
Marital Status:
Name of Spouse:
Ethnic Origin Information:
Other-Specify:
Payment Plan: 1, 2, or 3

Educational Information

Name of High School
High School Graduation Date
City:
State:


Previous Education

In order to evaluation your previous college credits, please provide Bethany with the following information. List all colleges attended in chronological order, (beginnning with the first and ending with the last).

You may receive advanced standing for transfer credits earned from other acceptable colleges and seminaries and/or Life Learning Experience and apply them toward your degree program. Bethany only allows 30 credits for life learning and that can only be applied in the undergraduate level. However, and advanced standing, whether it is transfer credits or credit received from Portfolio Learning Assessment, shall in no instance preclude a minimum of 30 credit hours of study with Bethany.

Schools Previously Attended

Name of Institution:
City:
State:
Hours completed:
Dates attended:
Institution Degree:
Institution Graduation Date:

Name of Institution:
City:
State:
Hours completed:
Dates attended:
Institution Degree:
Institution Graduation Date:

Name of Institution:
City:
State:
Hours completed:
Dates attended:
Institution Degree:
Institution Graduation Date:

What degree program do you desire to enroll?

Bachelor:
Master:
Doctorate:


Do you have any life-learning experience that you would like to be considered? In the box below give a brief summary of your life-learning experience that you think might apply towards credits.

A one time $50.00 Application/Evaluation fee is required to submit an application for enrollment or evaluation. If the student completes the enrollment, the $50.00 fee will be deducted from the overall cost of the selected degree program.

Credit Card Information

Type of Credit Card:
Expiration date:
Card number:
Name on card:
Authorization Code:
(3-4 digit number found on the back of your card.)


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