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Baptist College of America
Application for Enrollment
 

Personal Information
Last Name:    
First Name:    
Middle Name:    
Mailing Address:    
City:    
State:    
Zip:    
Home Phone:    
Work Phone:    
Email Address:    
Preferred Method of Contact:     Email 
      Phone
      Mail   
   
Date of Birth:    
Social Security Number:    
Sex:     Male   Female
   
Marital Status:     Single Married Divorced Other
Name of Spouse:    
Number of Children:    
How did you hear about BCA?    
Into which program do you wish to enroll?    

Ethnic Origin
(This information is required by the Civil Rights Act)
Caucasian (Non-Hispanic):
Hispanic:
Black (Non-Hispanic):
Asian Pacific Islander:
American Indian/Alaskan Native:
Korean:
Other;
(Specify):
Citizenship
Place of Birth:
Are you a Citizen of the
United States?		     Yes   No
If NO, of what country are you
a resident?
Are you a permanent U.S. Resident?     Yes   No
If YES, do you have a
Green Card?		     Yes   No
Number:
Education Information
Name of High School:
City:
State:
Graduation Date:
Did you Graduate?     Yes   No
If NO, do you have a G.E.D?      Yes   No
List all colleges attended in chronological order (most recent first)
College #1
Name of Institution:
City:
State:
Dates Attended:
Degrees Received:
Hours Earned:
Semesters:
Quarters:
College #2
Name of Institution:
City:
State:
Dates Attended:
Degrees Received:
Hours Earned:
Semesters:
Quarters:
College #3
Name of Institution:
City:
State:
Dates Attended:
Degrees Received:
Hours Earned:
Semesters:
Quarters:
Additional Colleges:
Are you currently enrolled in the last institution attended?     Yes   No
If YES, what will be your last date of attendance?
Are you eligible for readmission to that institution?     Yes   No
If NO, are the reasons:     Academic   
      Disciplinary 
      Other          
Please Explain:
What City, County, or Institutional Library/s can you use for research and reference materials?


                     (This cannot be your personal library)
Number of Volumes in Library:
Background Information
Present Occupation:
How long employed?
Employer:
Address:
Have you ever been convicted for the violation of any Federal, State, County, or Municipality Law?
(Excluding minor traffic violations)		     Yes  No
If YES, please explain:
Name of local Church:
Address:
Phone:
Pastor's Name:
Phone:
Are you a minister?     Yes   No
Are you licensed?     Yes   No
Are you Ordained?     Yes   No
Are you a Veteran?     Yes   No
How long have you been in Full-Time Service?
What denomination do you classify yourself as being?
References
Friend or next of kin:
Phone:
Friend or next of kin:
Phone:
Friend or next of kin:
Phone:
Please give a brief testimony of your Salvation Experience:

Financial Information
Tuition and fees are due at the time of enrollment. However, in an effort to aid the student, we have provided three payment options.
(Note: Discounts are for TUITION ONLY. Application and registration fees are not discounted)

Please select one option and which monthly payment you would like.

Bachelor Program Tuiton - $1600/yr.
Option
(Choose one)

Tuition
Discount

Down
Payment

Monthly Payments (pick one)

12

18

24

1

0% $250 $112 $81 $65
2 5% $500 $85 $57 $43
3 10% $1440 None None None
Masters Program Tuition - $1920/yr.
Option
(choose one)		 Tuition
Discount		 Down
Payment		 Monthly Payments (pick one)

12

18

24
1 0% $250 $139 $98 $78
2 5% $500 $111 $74 $56
3 10% $1728 None None None
Doctorate Program Tuition - $2240/yr.
Option
(choose one)		 Tuition
Discount		 Down
Payment		 Monthly Payments (pick one)

12

18

24
1 0% $250 $165 $115 $91
2 5% $500 $136 $91 $68
3 10% $2016 None None None
           
REFUND POLICY
The $35 Application fee is non-refundable. If the student has received course materials, the $50 Registration fee is also non-refundable. If the student elects to withdraw, they will be charged a $35 Withdrawal fee.

The signing of this application is considered signing a contract with BCA. Fifteen days after receiving the study guide materials the student is liable for the entire amount of the program in which he or she enrolls.

I understand that my signature on the Final Approval section of this application will constitute a contract with the college concerning my liability.