FOR OFFICE USE:

Instructions: Print this form. Complete and mail it to the above address with the enrollment fee of ten dollars. 

Name…………………………………………………E-mail……….……………………..

DOB………………………………Nationality…………………………………………….

Home Address………………………………………………………………………………

Mailing Address (if different)………………………………………………………………

Home Phone (       )…………………………Work Phone (       )……………………………

Marital Status (  )    Married (  )   Single (   )   Divorced (  )   Widowed (  )    Separated  (  )

No. of Children  1  2  3  4  5  6  7  8  9   10  More…….. Ages….......…………………...............

Are you a Veteran of the Armed Forces?  (  )   Yes  (  )   No

Your Church Membership…………………………………………………………………

Name of Your Pastor……………………………………………………………………….

Your Pastor’s Address……………………………………………………………………...

School Season being applied for: ( ) Fall ( ) Spring ( ) Summer

Intended Course of Study at MTC..........................................................................

Check one: Raleigh Location or Online Campus

Your Immediate Goal in Ministry…………………………………………………………..

Your Ultimate Goal in Ministry…………………………………………………………….

High School Attended……………………………………………… Graduated…………..

College Attended…………………………………………………… Graduated…………..

Address of College………………………………………………………………………….

Names and Addresses of two (2) references for recommendation purposes.

1……………………………………………………………………………………………

2……………………………………………………………………………………………..

Applicant’s Signature………………………………………Date………………………….

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