VBC Student Application

Application for Admissions

Confidential

Please complete the information below, or you can apply by telephone at (336) 759-0591. You may also print this form and fax or mail to: Vintage Bible College, 4964 University Pkwy. Suite 105, Winston-Salem, NC 27106. Our fax number is (336) 759-0592. If you have any questions or prefer to speak with an admissions counselor by phone, you may contact us at (336) 759-0591. Thank you for your confidence in Vintage Bible College & Semina

PERSONAL INFORMATION

Title:

First Name: *

Last Name: *

Gender: *

Male Female

Date of Birth *

Last 4 digits of your Social Security Number (If none, state "NONE")

Email Address: (If none, state "NONE" ) *

Daytime Phone: (If none, state "NONE" ) *

Evening Phone:

Street/Mailing Address: *

Address 2

City: *

State: *

Zip Code: *

Degree/field of study desired:

I am interested in the following studies:

On-campus Online studies

I am a Christian?

Yes No Unsure

Background/Affiliation

MINISTRY / OCCUPATIONAL EXPERIENCE

Occupation:

Involved in Ministry? (if so, state type)

EDUCATION

High School:

Street Address:

City, State, Zip:

Dates Attended:

Level Attained: *

List your previous college/university/trade schools attended, beginning with the most recent.

College/School:

Street Address:

City, State, Zip:

Dates Attended:

Field & Level of Study:

Degree/Diploma Earned?

Yes No

College/School:

Street Address:

City, State, Zip:

Dates Attended:

Field & Level of Study:

Degree/Diploma Earned?

Yes No

College/School:

Street Address:

City, State, Zip:

Dates Attended:

Field & Level of Study:

Degree/Diploma Earned?

Yes No

PERSONAL EXPERIENCE

Do you desire to transfer credits earned from previous schools to VBC?

Yes No

List all life learning experiences you are requesting to be considered for credit (ministry, life experiences, credentials, accomplishments, internships, military, vocational, professional, etc.).

* Optional : You may attach a detailed resume of your experiences (Microsoft Word .doc only)

I certify that the information provided by me is true to the best of my knowledge. I acknowledge that I have access to a copy of the student catalog . I understand that all items related to the application process become the permanent property of Vintage Bible College. *

Yes No

Date of application *

Date

APPLICATION FEE

There is a one time $30.00 application fee (non-refundable). When you select the Submit button below, you will be directed to submit payment information, or, if you prefer, you may contact Vintage Bible College & Seminary by phone at (336) 759-0591. Application is not complete without application fee.

Thank you! We look forward to having you study at Vintage Bible College! Vintage Bible College 4964 University Pkwy. #105, Winston-Salem, N.C.27106 www.vintagebiblecollege.org (336) 759-0591

Note : We do not sell or distribute any information that you provide us to outside parties unaffiliated with Vintage Bible College; however, you may receive periodic updates or promotions from us.