Application for admission

The "Kingís" College

2910 Douglas Rd., Cortland, New York 13045

(607) 756-5770

Application for Admission

To the applicant:

  1. Please attach a CURRENT photo. Head and shoulders only.
  2. Enclose the non-refundable application fee.
  3. All letters of recommendation must be received by the Admissionís office before your application can be processed.
  4. Please type or print clearly answering all questions.

Personal Data

  1. Name:_________________________________________________

Last First Middle Maiden

Present Address:_______________________________________________________

Street and Number City or Town State Zip

Present Phone Number (____)_____________Social Security No._____/_____/_____

Date of Birth_____/_____/_____ Age_________ Sex: M F

Mo. Day Year

2. Are you a United States Citizen?___________ If no, what country?_____________

3. Marital Status: Single 0 Married 0 Divorced 0


Widowed 0 Separated 0 Remarried 0

4. Dependent Information:

Name Age Sex Date of Birth




Personal Background

5.  Have you ever used tobacco, alcohol or        drugs?_______ If yes, when did you

    Last use them?____________ Do you currently use any now?__________

6.  Are you in debt?___________ How much?_________________________

7.  How do you plan on financing the college tuition?____________________

8.  Do you have a high school diploma?_________ If yes, when?___________

9.  Have you ever been expelled or suspended?_______ If yes, why?

10. Please list any advanced degrees earned or higher learning institutions attended.


11. Your general health is: Excellent 0 Good 0 Fair 0 Poor 0

12. State previous employment history:_______________________________



Christian Background

  1. Name of Church currently attending:_______________________________
  2. When were you born-again?_____________ Have you been baptized in the
  3. Holy Spirit?___________ Briefly describe your experience. ___________


  4. How long do you plan on attending here?___________________________
  5. What term are you planning to begin?______________________________
  6. What type of ministry do you feel God is calling you into and why?______
  7. What type of church involvement have you participated in?_____________
  8. On a separate sheet of paper describe: (a) Your regular prayer and bible study habits and; (b) Why you feel the Lord is leading you to The "Kingís" College.


20. Please give us the names and addresses of those individuals who will be

filling out your recommendation forms. Remember, your application can not

be processed until these are received.

Ministerís Recommendation:


Name of Minister & Church




Area Code & Phone Number

Personal Recommendation:

_________________________________ _________________________________

Name Name

_________________________________ _________________________________

Address Address

___(____)________________________ ___(____)________________________

Area Code & Phone Number Area Code & Phone Number

I hereby certify that the information given on this application is, to the best of my knowledge,

true and accurate. I understand that any false statement made on this application is automatic

grounds for rejection or dismissal from The "Kingís" College.


Signature_______________________________ Date___________________


["King's" College]