Bethany Theological Seminary Application for Admissions New Application Which program are you interested in?*MDivMAGraduate CertificateAuditing a courseOccasional coursesWhen would you like to begin?*August Intensive 2018Fall 2018Spring 2019May Intensive 2019Which course(s) are you interested in taking?*I plan to take the majority of my classes:*LocallyAs a Connections (distance) studentWhich MA Area of Concentration are you interested in declaring at this time?*Biblical StudiesBrethren StudiesHistorical StudiesPeace StudiesTheolgical StudiesUndecidedWhich MDiv Ministry Focus are you interested in declaring at this time?This is an optional part of the curriculum, not required.Conflict TransformationEducation & Human DevelopmentEvangelism & Missional ChurchPreaching & WorshipLeadership & AdministrationYouth & Young Adult MinistryUndecidedWhich MDiv Emphasis (using general electives) are you interested in declaring at this time?This is an optional part of the curriculum, not required.Biblical StudiesBrethren StudiesHistorical StudiesPeace StudiesTheological StudiesConflict TransformationEducation & Human DevelopmentEvangelism & Missional ChurchLeadership & AdministrationPreaching & WorshipYouth & Young Adult MinistryUndecidedWhich MA Emphasis (using general electives) are you interested in declaring at this time?This is an optional part of the curriculum, not required.Biblical StudiesBrethren StudiesHistorical StudiesPeace StudiesTheological StudiesConflict TransformationEducation & Human DevelopmentEvangelism & Missional ChurchLeadership & AdministrationPreaching & WorshipYouth & Young Adult MinistryUndecidedTo which higher education institution should we send your Bethany transcript after your occasional courses are completed?*Please list Institution name and address.Which Certificate would you like to apply for?*Certificate of Achievement in Theological StudiesCertificate in Biblical InterpretationCertificate in Conflict TransformationCertificate in Theopoetics & Theological ImaginationWhich course are you interested in taking?*Would you like to receive CEUs for this course?*Are you an International Student?*YesNoAre you associated with Ekklesiyar Yan'uwa a Nigeria (EYN)?*YesNoPersonal InformationFirst Name*Middle NameLast Name*Date of Birth*Social Security Number (if applicable)This is required for financial aid purposed. Street Address*City*State/Province/Region*Zip/Postal CodeCountry*Phone Number*Email* Demographic InformationGenderFemaleMaleOtherPrefer not to answerRace/Ethnic GroupPlace of Birth*Citizenship*Current Occupation*Marital StatusSingle/Never MarriedMarried/Domestic PartnershipDivorcedWidowedSeparatedHousehold MembersReligious AffiliationFaith TraditionCongregation*District (If Church of the Brethren)Ministerial StatusYear of Ordination/Licensure (if applicable)Ordaining/Licensing District or Judicatory (if applicable)Educational HistoryHighest Level of Educational Experience*No bachelor's degreeSome college courseworkBachelor's degreeSome graduate courseworkGraduate degreeName of Undergraduate InstitutionUndergraduate Institution City and StateDates Attended Undergraduate InstitutionDegree Achieved at Undergraduate Institution (if applicable)Name of Graduate Institution (if applicable)If you've attended more than one graduate institution, please list the most recent.Graduate Institution City and StateDates attended Graduate InsitutionDegree Achieved at Graduate Institution (if applicable)Background InformationHave you even been disciplined by a judicatory body responsible for ministerial ethics?*YesNoPlease explain your answer to the last question.*Employment HistoryEmployer 1*Employer 1 Address*Employer 1 Phone Number*Position Title at Employer 1*Employer 1 Supervisor*Dates at Employer 1*Responsibilities at Employer 1*Employer 2Employer 2 AddressEmployer 1 Phone NumberPosition Title at Employer 2Employer 2 SupervisorDates at Employer 2Responsibilities at Employer 2If there is a significant gap in your employment history, please explain.ReferencesAcademic Reference*Academic Reference E-mail Address*Church or Personal Reference*Church or Personal Reference E-mail Address*Payment MethodI will pay using:*Credit CardMailing in a checkI am a Bethany alumniApplication Fee Price: $50.00 Total $0.00 Please provide your check number below:*Credit Card American ExpressDiscoverMasterCardVisa Card Number Month010203040506070809101112 Year20182019202020212022202320242025202620272028202920302031203220332034203520362037 Expiration Date Security Code Cardholder Name Digital SignatureSignature*Use your mouse or a finger (if you have a touchscreen device).