Study Centre

Study Centre Code No:

Please tick the course you prefer ( √)D.D. - Doctor of DivinityD.Litt. - Doctor of LiteratureD.C.L.- Doctor in Christian LeadershipD.Min - Doctor of MinistryPh.D.- Doctor of Philosophy

Name
 Date of Birth

Age Church Denomination

Years of Experience in Ministry

Your Present Position in Church

PastorEvangelistDeaconTeacherBeliever

Are you married? NoYes If yes, spouse name

No of Children

Are you a Divorcee?NoYes If yes, reason

Permanent Address

Present Address

Nationality Mother Tongue

Phone (with code) Cell

Email Educational Qualification Secular

Educational Qualification SecularTheology

Name & Address of Last Institution, you studied

Name of your church Pastor

Your Church Location/ Place

D D Number Bank

DD/MO Date

I, hereby, declare that all the information given above are true to the best of my knowledge. I am solely responsible for my Christian life and conduct

Date

Upload Your Signature of the Candidate

Please Attach i) Xerox copies of all certificates and Mark sheets. (if possible, SSLC onwards)
ii) Brief Testimony of Conversion and Two Photo

Register Number

ADMISSION GRANTED/REJECTED

Remarks if any

Office Seal Date