Print Out & Mail to:
Freelandia Bible College & Seminary
130 E. Springbrook Rd.
Broadway, Va 22815-9526 USA
ENROLLMENT FORM (PLEASE PRINT CLEARLY)
Personal Data
Your Name_______________________________________________________________
Address____________________________________________________________________________
_________________________________________________Zip___________________________
Marital 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.)
Personal Commitment
(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.
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$20.00 predeposit enclosed____
Date__________________________
Signature___________________________________________________________
Social Security Number___________________________________________________________
Phone______________________________________________________________