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    CHRISTIAN ACADEMY FOR LEADERSHIP STUDIES

    Accredited Member of Nations Association for Theological Accreditation (NATA) South India Christian Council, Bangalore

    H.O.: 8/69C, Harris House, Alanchi Road, Rithapuram - 629 159

    Cell: 9442935233, 7502071054

    Study Centre: Study Centre Code No:

    Application for

    B.Th

    B.Min

    M.Div.

    M.Min

    M.B.S

    M.R.E

    M.Th

    PGADBC

    Please tick your
    choice

    C.Th/D.Th

    BBS

    B.T.S

    B.D

    M.C.S

    M.T.S

    M.A

    M.B.A

    M.S.W

    Lessons in Tamil / English

    Applied for: Regular/Part-time/Correspondence/ Open University System

    1.Name :
    2. Date of Birth : Age:Years:
    3. Father's/ Husband's Name :
    4. Church Denomination :
    5. Years of Experience in Ministry :
    6. Your Present Position in Church : Pastor/ Evangelist/ Deacon/Teacher / Believer
    7. Are you married? (Yes/No) If yes, spouse name: No of Children:
    8. Are you a Divorcee? (Yes/No) If yes, reason
    9. Permanent Address
    10. Present Address
    11. Nationality :Mother Tongue:
    12. Phone (with code) :Cell: Email:
    13. Educational Qualification : SecularTheology
    14. Name & Address of Last Institution, you studied:
    15. Name of your church Pastor :
    16. Your Church Location/ Place :
    17. D.D. Number :Bank: DD/MO Date:

    DECLARATION

    Date: Signature of the Candidate