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“C O N F I D E N T I A L”

CISTONLINE FREE BIBLE COURSES

FREE ENROLLMENT

|Date Today: |Month/Day/Year of REGISTRATION |

|New Module Course: |Write preferred Course Here: |

|Christian Foundation: | |

|Christian Growth: | |

|Christian Discipleship: | |

|Old Testament Study 1,2,3,4: | |

|New Testament Study 1,2,3: | |

|Christian Ministry: | |

|Family & Ministry: | |

|Christian Evidence Study: | |

|First Name: | |

|Middle Name: | |

|Last Name: | |

|Age / Birthdate / Birthplace: |Age / Month,Day.Year/Birthplace |

|Postal Address: | |

|Landline: | |

|Mobile Phone: | |

|City – Region – Country: | |

|ZIP CODE: | |

|Email Address: | |

|Facebook Page: | |

|Gender: Male or Female: | |

|Marital Status: Single, Married, Separated, |Answer Here |

|Divorced, Domestic Partners, Single Parent, | |

|Unmarried: | |

|Name of Spouse if Married: | |

|Contact Number: | |

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|EDUCATIONAL BACKGROUND |

|Graduated from High School? | |

|Yes or No | |

|Graduated from College? | |

|Yes or No | |

|College Course & | |

|Years Completed: | |

| Graduate School: | |

|Course & Years Completed: | |

|Other Courses: | |

|Course & Year Graduated: | |

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|RELIGIOUS BACKGROUND |

|Do you believe & receive Jesus Christ as Lord & | |

|Personal Savior? | |

|(Yes or No) | |

|Do you believe the Bible is the Word of God, the | |

|final authority in all matters of faith, conduct | |

|and truth? | |

|(Yes or No) | |

|Religion or Denomination: | |

|Church Name: | |

|Your Spiritual Leader, Pastor or Minister: | |

|Your Ministry Position or Church Involvement: | |

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|Please write something about our Courses and how | |

|it can help your ministry and spiritual growth? | |

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|REFERENCES |

|List down (3) references who can testify to your character and teaching ability. (Include a pastor, if possible.) |

|Title, Full Name: | |

|Email: | |

|Title, Full Name: | |

|Email: | |

|Title, Full Name: | |

|Email: | |

|Do you certify that the above information is true |Answer here |

|and correct to the best of your knowledge and | |

|ability, and the school has the right to deny any | |

|application for dishonest information. | |

|(Yes or No) | |

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|NOTE: PLEASE SAVE and then SEND IT BACK TO OUR DEAN… |

|Dr. Edwin M Gregorio |

|emgregorio@ |

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