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:
Phone
Date of Birth:
Social Security Number:
Sex
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?
If YES, do you have a Green Card? 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 #2
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?
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:
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 |
Down |
Monthly Payments (pick one) |
||
|
|||||
|
1 |
0% | $250 | $112 | $81 | $65 |
| 2 | 10% | $500 | $78 | $58 | $47 |
| 3 | 20% | $1280 | None | None | None |
| Masters Program Tuition - $1920/yr. | |||||
|
Option (choose one) |
Tuition Discount |
Down Payment |
Monthly Payments (pick one) | ||
|
|||||
| 1 | 0% | $250 | $139 | $98 | $78 |
| 2 | 10% | $500 | $102 | $73 | $59 |
| 3 | 20% | $1536 | None | None | None |
| Doctorate Program Tuition - $2240/yr. | |||||
|
Option (choose one) |
Tuition Discount |
Down Payment |
Monthly Payments (pick one) | ||
|
|||||
| 1 | 0% | $250 | $165 | $115 | $91 |
| 2 | 10% | $500 | $126 | $88 | $70 |
| 3 | 20% | $1792 | None | None | None |
POLICY AND DOCTRINAL STATEMENT
I agree to abide by the college regulations and
policies as set forth in the Baptist College of America catalog. Also, by
signing
this application, I certify that I have read, I understand, and I respect the
doctrinal statements presented in the college catalog.
Signature
Date
When you have completed this entire
application, print the entire application and sign and date. Mail this to BCA
along with your payment.
Baptist College of America
1700 S. Goyer
Kokomo, IN. 46902