APPLICATION FOR AD

ISSION

APPLICATION CHECKLIST All applicants must submit the following to complete the application process: $25 Application Fee Photograph Pastoral Recommendation Personal Recommendation Copy of High School Diploma or equivalent International applicants must also complete the following: F-1 or M-1 Immigration Responsibilities International Student Personal Data Financial Guarantee for Admissions International Student Financial Worksheet These forms can be obtained at the VBI office or downloaded from our website at www. Lewis Ave.vbitulsa. Tulsa. Application and all required documents should be submitted to: 7700 S. All items on this checklist must be submitted to VBI before your application will be reviewed for acceptance. Ok 74136 1 .com.

Student ID # _________________ PERSONAL INFORMATION Have you been a student at VBI before? Yes No If yes. A passport picture is recommended. Full Legal Name Mr. then complete the Readmission Application.S. U. _____ Marital Status: Separated Divorced Other (please specify) ____________________ Widowed Single Engaged Married Number of Children ______ Ages ______________ How did you hear about VBI? __________________________________________________________ 2 .S.S. Visa Type _____________________________________ Number of years in the U.APPLICATION FOR ADMISSION Office use only: Attach a recent photo here Application Fee Photograph Pastoral Recommendation Personal Recommendation Diploma or Transcripts Head & shoulders photo only Do not send application without PHOTO. NOT this application. Mrs. First Name (Given name) _________________ Last Name (Surname) ____________________ Preferred Name ________________ Social Security # _________________________________ Mailing Address______________________________________________________________________ City __________________ State _____________________ Country_ __________________________ Zip Code _________ Home Phone ( Work Phone ( ) ____________ Cell Phone ( )_ ___________________ ) ______________ Email_ ______________________________________________ Date of Birth ____/____/____ Age _____ Place of Birth City _____________ State _____________ Country ________________ Citizen of: Permanent Resident/Green Card U. Miss Rev.

FAMILY INFORMATION Spouse’s Name: First ________________________ Last______________________________________ Occupation ________________________ Denomination_____________________________________ Has your spouse accepted Christ as his/her personal Savior? Yes No If yes. how long ago? ______ Is your spouse in favor of you attending VBI? Yes No Father’s Name: First _________________________ Last _ ____________________________________ Address _______________________________________________ City__________________________ State ___________ Zip Code _____________ Home Phone ( )_____________________________ Denominational Preference_____________________________________________________________ Mother’s Name: First _________________________ Last _ ___________________________________ Address _______________________________________________ City__________________________ State __________________ Zip Code _____________ Home Phone ( )______________________ Denominational Preference_____________________________________________________________ SPIRITUAL INVENTORY Home Church _____________________ Denomination_ _____________________________________ Pastor’s Name: First ________________________ Last _ _____________________________________ Address _______________________________________________ City__________________________ State ________________ Zip Code _____________ Phone Number ( )______________________ How long have you attended?_ _________________________________________________________ Have you accepted Christ as your personal Savior? Yes No How long ago?_______________ Have you ever used or been involved in the following? (If yes. how long ago did it take place?) Alcohol Yes No _______ Years ______ Months Drugs Yes No _______ Years ______ Months Gambling Yes No _______ Years ______ Months Eating Disorders Yes No _______ Years ______ Months Homosexuality Yes No _______ Years ______ Months Pornography Yes No _______ Years ______ Months Sexual Promiscuity Yes No _______ Years ______ Months 3 .

do you have a GED? Yes Yes No No Please list all the academic institutions you have attended from high school and beyond.EDUCATIONAL INFORMATION Are you a high school graduate? If no. list below: Starting Dates Do you owe any student loans? Yes Current Balance Monthly Payment No If yes. please explain: _________________ ______________________________________________________________________________________ Do you have any outstanding balances at VCC. Name & Address of School Dates From/To Course of Study Degree or Diploma List any special ministry experience or talents: FINANCIAL INFORMATION How do you plan to pay for school expenses? Personal Employment_ Spouse Employment Savings Other (list) _______________________________________________ Do you have any financial obligations that will hinder your commitment to VBI? Yes No Creditor Name If yes. (including VCS) 4 Yes No .

please explain ___________________________________________________________ Are you presently taking prescriptions of any kind? Yes No If yes. do hereby state that on the date indicated I grant full permission to Victory Bible Institute.HEALTH INFORMATION Give a brief statement of the general condition of your health. weaknesses or chronic diseases that Yes No could interfere with your performance at VBI? If yes. or any related or consulting physician. I grant complete permission for such care and treatment to be given. Signature __________________________________________ Date ____________________ 5 . please explain ___________________________________________________________ Do you have any physical conditions. ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ Have you been diagnosed with any medical illness? Yes No If yes. to render or give emergency medical care or treatment that is deemed necessary. I also state that by granting such permission. the undersigned. I absolve Victory Bible Institute of any financial liability pertaining to such medical treatment or hospitalization. whom should we contact? Name: First ______________________________ Last _ _______________________________________ Address ____________________________________________ City______________________________ State _______________ Zip Code _____________ Home Phone ( Work Phone ( )__________________________ )______________________________________________________________________ MEDICAL CONSENT I. I also state that should extended hospitalization be required. mental illness. please explain ___________________________________________________________ ______________________________________________________________________________________ In case of a medical emergency.

6 .TEST IMONY Provide us with an account of your personal testimony. Include: why you feel called to Victory Bible Institute. your experiences when you were filled with the Holy Spirit and your deliverance from any activities as stated on the Spiritual Inventory section of this application.

My signing today is my acknowledgement to honor the Lord Jesus Christ. I commit to grow in my spiritual pursuits by developing a personal relationship with the Lord Jesus Christ through Bible study. cheat or participate in any academic dishonesty including plagiarism or cheating. the conduct of the student is deemed to violate VBI’s ideals of scholarship or its’ spiritual or moral atmosphere as a Christian institution. drinking alcoholic beverages.CODE OF HONOR Honor is a concept that is one of the cornerstones of the Christian faith. and viewing pornographic materials including internet pornography. cheat. respect or having a good name. including VBI. I commit to cultivating good relationships by a lifestyle of integrity and honesty. I will not lie. I commit to demonstrate integrity in all of my personal and academic pursuits. upright. you are committing to living a lifestyle of the highest level. I commit to pursue God’s will for my life and to live a life of service while attending VBI. I commit to developing the whole person in body. I commit to abide by the rules and regulations of VBI which may from time to time be altered or changed by the institution. The term honor means integrity. sexual misconduct. it will be grounds for either denial of admission or immediate dismissal from VBI. I will not physically or verbally abuse any person or thing. understand that if VBI is notified that any information contained in this application is false. I commit to take care of my financial obligations. I will promote my lifestyle that will influence all other students positively. I commit to be punctual and to attend all required classes. Any violation of this Code is grounds for dismissal by VBI. I will keep from any illegal or unethical acts. the taking of illegal drugs. prayer and worship. steal or gossip. VBI reserves the right to require the withdrawal of any student if. VBI housing. and other personal obligations in a responsible and timely manner. To this end. the undersigned. This would include but not be limited to sexual immorality. hereby state that the information contained in this application is true and correct. By signing the Code of Honor. Statement of Truth I. I. mind and spirit. In doing so. I commit to live a life of purity and integrity. services and activities held by VBI and my local church. respect. you are recognizing that VBI is committed to help you live a life of the highest caliber with regard to reputation. In this act of commitment. I will not lie. honesty and moral integrity. The signing of the Code of Honor acknowledges I have read and agreed to the above criteria for the admittance into VBI. in the judgment of the Director of VBI or the administrative team of Victory Christian Center. Signature _________________________________________ Date ___________________________ 7 . homosexual behavior. VBI and to adhere to the following: I commit to apply myself wholeheartedly to my academic studies and intellectual pursuits for the glory of God. I understand that in order to maintain the highest levels of training and to safeguard its ideals of spiritual and moral values.

liabilities and damage that could arise from disclosure of information consistent with authorization.PASTORAL RECOMMENDATION This section should be completed by the applicant Name: First ______________________________ Last _ ______________________________________________ Address ____________________________________________ City_____________________________________ State ________________ Zip Code ____________ Home Phone ( )_________________________________ I authorize the pastor listed on this form to complete this recommendation and return it to VBI. I release this pastor and VBI from all claims. I this applicant for admission. Signature _____________________________________ Date _________________________ A pastor should complete this section Pastor’s Name: First ______________________________ Last _________________________________________ Church Name ___________________________ Denomination ____________________________________ Address ____________________________________________________ City______________________________ State __________________ Zip Code _____________ Work Phone ( )________________________________ How long have you known the applicant? ____________________________________________________ How well do you know the applicant? Very Well Well Casually Do you believe the applicant has a personal relationship with Jesus Christ? Yes No Do you believe the applicant possesses the necessary qualities to succeed at VBI? Yes No If no. I understand that this form is confidential and that I will not be entitled to review the completed document. strongly recommend recommend do not recommend Signature ________________________________________ Date ______________________________ 8 . what are they lacking? ____________________________________________________ Rank the following areas: Leadership Emotional Stability Peer Relationships Spiritual Maturity Morality Social Skills Submission to Authority Excellent Above Average Average Below Average Comments ___________________________________________________________________ Is there any reason why the applicant should not be admitted to Victory Bible Institute? _____________________________________________________________________________ Based on the above information.

I this applicant for admission. liabilities and damage that could arise from disclosure of information consistent with authorization. what are they lacking? ____________________________________________________ Rank the following areas: Leadership Emotional Stability Peer Relationships Spiritual Maturity Morality Social Skills Submission to Authority Excellent Above Average Average Below Average Comments ___________________________________________________________________ Is there any reason why the applicant should not be admitted to Victory Bible Institute? _____________________________________________________________________________ Based on the above information. strongly recommend recommend do not recommend Signature ________________________________________ Date ______________________________ 9 .PERSONAL RECOMMENDATION This section should be completed by the applicant Name: First ______________________________ Last _ ______________________________________________ Address ____________________________________________ City_____________________________________ State ________________ Zip Code ____________ Home Phone ( )_________________________________ I authorize the person listed on this form to complete this recommendation and return it to VBI. Signature _____________________________________ Date _________________________ A FRIEND should complete this section Friend’s Name: First ______________________________ Last _________________________________________ Church Name ___________________________ Denomination ____________________________________ Address ____________________________________________________ City______________________________ State __________________ Zip Code _____________ Work Phone ( )________________________________ How long have you known the applicant? ____________________________________________________ How well do you know the applicant? Very Well Well Casually Do you believe the applicant has a personal relationship with Jesus Christ? Yes No Do you believe the applicant possesses the necessary qualities to succeed at VBI? Yes No If no. I release this pastor and VBI from all claims. I understand that this form is confidential and that I will not be entitled to review the completed document.

vbitulsa. OK 74136 918. VBI does not discriminate on the basis of race or color. national and ethnic origin or disability.com VBI is a ministry of Victory Christian Center.491. Lewis Ave. . Tulsa.7700 S.7600 www.