FORM

Kingsway Institute Of Education & Religious ST.
                    An International Advance Bible College ( Non-Denominational).

Office: Avenida Del Puerto 56-5-20,Postal Code 46023, Valencia Spain

Tel:+34-606-827-665 , +34-606829862

APPLICATION FOR ADMISSION

                Date:

I.            PERSONAL DATA

1.        Name ___________________________________________________________________ Phone ______________________ S.S. #

2.        Permanent Address _______________________________________________________ City _______________ State ________ Zip ____

3.        Date of birth _____________________________ Age _________ Place of birth _________________________________________ Sex _

4.        Indicate your status: Single ___________ Engaged __________ Married ___________ Widow(er) ___________ Divorced ___________

5.        Name of spouse _

6.        Give the number, _________, names, sex and ages of the children you will have with you: ___

_______

_______ _______

7.        Name of parent or guardian ____________________________________________________ Relation _______________ Phone _

8.        In case of emergency contact:

9.        What is your present occupation? ____________________________________________________ In the past?

10.     Do you have any major physical disabilities ________ If so, what?

11.     Do you use tobacco, drugs or alcoholic beverages?

II.            EDUCATIONAL BACKGROUND

1.     Did you graduate from high school? _______ Where? ___________________________________________________________ Year? ____

2.     What other schools beyond H.S. have you attended?

______________________________________________________ Did you graduate? ________ Degrees? _

3.        Have you studied any foreign languages? __________ If so, which? ___________________________________ How much? _

4.        Have you ever been expelled or suspended from any school? ________ If so, why? __

III.       CHRISTIAN EXPERIENCE

            1.     How long have you been a born again Christian? ________ Have you been filled with the Holy Spirit? _______ If not, do you desire to be?

            2.     What call of God, if any, do you feel upon your life? __

            3.     Of which church are you a member? ___

            Address __________________________________________ City ________________________ State ________ Zip ____________ Phone _____

4.        What Christian work have you done? __

IV.           REFERENCES

1.     Who recommended KIERS to you? ___

2.     Give the names and addresses of your pastor and two other responsible persons who know you well. No relatives, please.

              Name Address        City       State          Zip     Phone

Pastor _____________________________________________________

___________________________________________________________

_____________________________________________________________

Note: Enclosed are 3 Confidential Reference Forms for you to give to the above listed persons – NOT RELATIVES. Be sure to give the BLUE form to your Pastor and one of the other forms to each persons listed above. Be sure to PRINT their names in the first blank line at the top of the page and your own name on the second blank line. These Confidential Reference Forms are to be completed and mailed by them, DIRECTLY BACK TO US. If you did not receive these forms, check this space _______ and we will mail the forms to the above people.

V.             GENERAL PLANS

1.        With which semester do you wish to begin? Fall (August) _____________ or Spring (January) _______________. Which year? ____________

2.        Do you have the financial resources for your 1-2 Yrs or ( Six month ) of schooling? _____

3.        Do you plan to work part-time? ________ What special skills do you have? __

4.        Are you in debt? _______ If so, how large is your total debt? _____________

5.        Does anyone depend on you for financial support (give details)? __________________________________________________________________

6.        If engaged, please state your plans; if married, mention your plans for your family while you are in school. ________________________________________

_______ ________________________________________________________

7.        On what date do you plan to arrive at Kingsway

VI.       ADDITIONAL INSTRUCTIONS: (Check off the items as you complete them.)

1.        Please include a recent photo or snapshot of yourself with this form.

2.        Include the application fee of $30 with your letter.

3.        Submit a letter of approximately 150 words giving your personal testimony and your purpose in coming to King’s Way.

4.        Please be advised that due to a minimum rate for housing and tuition, students are required to perform 2 hours of work per week on campus.

5.        Upon your acceptance, it is a Texas law that you submit a shot record from a physician showing that you have had diphtheria and tetanus shots within the last 10 years. Also, your children will need the same, plus a record of polio immunization.

6.        NO PETS are allowed in housing.

I affirm that if I am accepted as a student at The Kingway Institut Of Education & Religious Studies, I will endeavor to cooperate with the administration of the Institute.

Date ________________________________ Signed__________________________