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NEW ENGLAND BIBLE INSTITUTE

&

THEOLOGICAL SEMINARY
Facebook.com/shalommissionarychurch

ADMISSION APPICATION FOR ALL REGULAR STUDENTS

Each applicant must provide The N.E.B.I.T.S with the following information: Just
complete the form and return it by postal mail with the proper fee. Please supply us with a
small recent passport type photo of yourself if you have one, or perhaps you could send it
later. If your spouse will also be a student of The New England Bible Institute &
Theological Seminary please make a photo copy of this application for them, and note the
discount for married couples mentioned in the catalog.

PLEASE TYPE OR PRINT PLAINLY

Name …………………………………………………………………………………….............
(As it should appear on all diplomas and degrees)

Street address or P .0. Box:…………………………………………………………….............

City…………………………………………………….…… State ……..Zip……....................
Phone: Res…………………………………………….. Bus…………………………….........
Date of Birth ………………………………...............................................................................

Marital Status (check one)

 Single
 Married
 Separated
 Divorced
 Remarried
 Widow/Widower

Specific Occupation……………………………………………………………………............
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On the back or a separate sheet of paper write a paragraph testimony of when, where, and
how you were saved.

Denominational Background ……………………………………………………………............

Name and address of local church I presently fellowship and worship with:

Name of Church ………………………………………………………………………….............

Pastor’s Name……………………………………………………………………………..............

Mailing Address………………….……………………………………………………….............

City……………………………….………………………. State……….. ...Zip………................

PREVIOUS SCHOOLING

I am a high school graduate Yes No

I have a G.E.D. Yes No

I am a college transfer Yes No

List all schools beyond high school you have ever attended:

Name of School City/State Courses Taken Year Date

………………………………………………………………………………………………......

……………………………………………………………………………………………….....

……………………………………………………………………………………………….....

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What are your educational goals? (Desired degrees and in what fields?)

………………………………………………………………………………………………...........

………………………………………………………………………………………………...........

………………………………………………………………………………………………...........

………………………………………………………………………………………………...........

Provide the name and complete address of a Christian friend who has known you for at
least one or
two years.

Name………………………………………………………………………………………….......

Street Address or P.O.

Box……………………..................................................................................................................

City ……………….............State…........................................................................Zip................

CONFIRMATION

I have examined The New England Bible Institute & Theological Seminary Catalog, and I
hereby request to become a regular credit-degree student. I understand that if I wish credit
and certificates that there is a cost for the Course Books and an additional degree fee as
described in the catalog. I also understand that there are written papers required for the
Master and Doctorial degrees.

I am in general agreement with the Doctrinal Statement; and promise to abide by the
Conduct Standards. I certify that all the information on this application is true and
accurate to the best of my knowledge.

Signature…………………………………………Date ………………….................................

Most schools have a non-refundable registration fee of $25 to $100, but the New England
Bible Institute & Theological Seminary only requires that you order a minimum of one
Course at this time. Prices are in the Catalog. Applications for admission without proper
fees will not be processed. There is no other formal contract between this school and our
students. You will receive your Course usually in a week or ten days after we receive your
application and fee. Please do NOT send cash. Make checks or money orders payable to:
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YOUR PERSONAL TESTIMONY OF SALVATION EXPERIENCE

NEW ENGLAND BIBLE INSTITUTE & THEOLOGICAL

SEMINARY
Dr. Pierre B.Gnanzou, Chancellor
561 Main Street
Melrose, MA 02176
Phone (617)501-4024
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pbgaby3@gmail.com