Freelandia Bible College & Seminary 130 E. Springbrook Rd. Broadway, Va 22815-9526 USA
ENROLLMENT FORM (PLEASE PRINT CLEARLY) Personal Data Your Name_______________________________________________________________
Address____________________________________________________________________________ _________________________________________________Zip___________________________ Marrital Status__________________________ Age_________ Sex_________ Occupation________________________________________________________________________ Denomination______________________________________________________________________ Activities_________________________________________________________________________ Do you have eternal life?___________________________________________________________ Why?_______________________________________________________________________________ Who is Jesus Christ?_______________________________________________________________ _______________________________________________________________________________________ Do you agree with our statement of faith?______________________________________________ Studied our Catalog?__________________________________________________________________ Do you have a Scofield Bible?__________________________________________ How many hours can you study weekly?____________________________________ Where did you learn about Freelandia?_______________________________________________________________ _________________________________________________________________________________________________ Name post-secondary schools attended, years, credits and degrees:____________________________________________________________ ____________________________________________________________________________________ ___________________________________________________________________________________
Program Choice 1. I want to study for a (check one): Degree_____ Diploma_____
2. I want to major in (check one):
Biblical Studies___ Biblical Theology____ Ministerial Theology____ Christian Education____ Biblical Counseling____ Career Ministries____
3. I want to begin my studies at the following program level (check one): Counselor(1st year)___ Associate(2nd year)___ Specialist (3rd year)___ Bachelor (4th year)___ Master (5th year)___ Doctor(6/7th year)___
4. I want to transfer college or seminary credit for courses completed at other schools. I am requesting these schools to send official transcripts to Freelandia. Yes___ (Levels above 1st year require official transcripts.)
(Check all boxes below) __I have filled in the above personal data completely and do hereby make application to enroll as a student at Freelandia.
__I am applying for a tuition free scholarship toward a Freelandia degree(or diploma) program (value up to $3000 per full year credit for which benefit there is no charge). This scholarship will be extended beginning with each new school quarter as I continue faithful in my commitments to the school.
__I am enclosing $20 predeposit for the College Library to be refunded promptly if I am not accepted as a student. Upon notification of my being accepted as a student I will send an additional $30 deposit to the Library.
__I understand that my total $50.00 deposit to the Library will be promptly refunded only upon completion of my degree program, less costs due to any loss or damage to the books or tapes loaned to me.
__I will pray for and contribute to the school in a manner worthy of the Lord and the sacrifices made by the school staff to make my training possible. I understand that all the contributions to the school are used 100% in the Lords work through the school.
1. Upon notification of my being accepted as a student I will contribute (check one amount): $50___$75___$100___$200___$250___.
2. Every 30 days thereafter until I complete my program I will contribute (check one amount): $25___ $35___ $50___ $75___ $100___ $150___ $200___ $250__.
__I am prompted to become a student of Freelandia by my desire to know and obey the Lord Jesus and God's Word in fullness. I promise with Gods help to pursue my program faithfully unto completion.
Signature___________________________________________________________ Social Security Number___________________________________________________________ Phone_______________________________________________________________