GENERAL INFORMATION
 
  Referred By
First Name
Middle Name
Last Name
Street Address
Apt.#
City
State
Zip code (Postal code)
Country
Social Security #
Telephone (home)
Telephone (cell))
Telephone (work)
E-mail Adress
Gender
Male Female
Place of Birth
(City, State, Nation)
Citizenship
United States Other
Date of Birth
(mm/dd/yy) Age
Marital Status
Single Married Re-Married
Separated Divorced Widowed
Spouse's Name
 
DEGREE PROGRAMS
When do you plan to enroll?
Fall Spring Summer - RU offers open Enrollment
Do you plan to attend
Full Time Part Time
Undergraduate Programs
Chaplaincy Certificate
Certificate of Ministry
Associate of Theology
Associate of Christian Counseling
Associate of Ministry

Bachelor of Ministry
Bachelor of Thelogy
Bachelor of Christian Counseling
Bachelor of Elem. Education

  Graduate Programs
 

Master of Theology
Master of Ministry
Master of Christian Counseling
Master of Business Administration

Doctor of Theology
Doctor of Christian Counseling
Doctor of Ministry

   
EDUCATION INFORMATION
College/ Unversity
Dates
To/From
Field of Study
Degree Earned or
Hours Completed
CHURCH INFORMATION
Name of Local Church you attend
Are you a Member?
Yes No
Years of attendance
Pastors and Ministers Only
Are you a licensed minister?
Yes No
Are you currently in ministry?
Yes No
Position
Are you ordained?
Yes No
CREDIT CARD INFORMATION
In order to process your application for review/enrollment, a non-refundable
application fee of $50.00 USD is required and an Admissions Counselor will
contact you after reviewing your submission.
*First Name
*Last Name
*Type of card
Visa Master Discover
*Card Number
*3 Digit (CSC)
(on the back of card)
*Expiration Date
Month Year

I have read this on-line presentation of Rhema University and agree to abide by the standards
as set forth. I have told the truth to the best of my ability on this application. I
further acknowledge that no other representations have been made to me in
writing or orally other than what is stated in this on-line presentation. I
understand that all information given in this application is subject to verification
and will be confidential.

                             Place your name here as your Signature Date