Student Application ~ SMBI

1 Personal Information

2 Academic Information

3 Student Pledge

4 Payment

Name
First Middle Last (Maiden)
Birth Date*
Age
Address
Street Address City State / Province / Region ZIP / Postal Code Country
Phone
Email
Gender
- Male
- Female
Citizenship
Do you have a personal website?
- Yes
- No
Website Address
Marital Status
- Single
- Married
- Widowed
Will your spouse be attending also?
- Yes
- No
Children
Please list the names and ages of any children that will be coming with you
Have you attended SMBI before?
- Yes
- No
When did you attend?
Check all that apply:
- Teaching at a christian school within one year prior to enrollment
- VS of one year or more ending within one year prior to enrollment
- Child of and fully supported by an ordained or licensed person
- Full-time missionary
- Ordained or licensed
- Desire to work for a diploma
What year do you project graduating?
Which major do you prefer?
- Bible & Theology
- Christian Education
- Missions
Specify any dietary needs (extra fees may apply):
Family Information
Father's Name
Parent's Phone
Parent's Email
Occupation
Address
Street Address City State / Province / Region ZIP / Postal Code Country
Father's Status
- Deceased
- Ordained or licensed
- Full-time missionary
Mother's name
- Contact information is same as above
- Deceased
Address
Street Address City State / Province / Region ZIP / Postal Code Country
Church Information
Name of church you presently attend:
Name of conference or fellowship:
Pastor's Name
Pastor's Phone
Pastor's Email
Address
Street Address City State / Province / Region ZIP / Postal Code Country
Do you have any questions?

Student Application

Family Information

Church Information

First Year Students Only

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