| Personal Information |
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First Name:
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| Last Name: |
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Middle Name: |
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Gender:
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Male
Female |
| Address: |
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| City: |
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| State: |
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| Zip
Code: |
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| Home
Phone: |
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| Day
Phone: |
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| Date
of Birth: |
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E-mail Address: |
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Nationality |
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Marital Status: |
Married |
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Widowed |
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Single |
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Separated |
| If
married, have you or your spouse been divorced? |
Yes
No |
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yes, please briefly explain:
Admissions Policy
Manual.pdf |
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| Name
of spouse:: |
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Names and ages of your dependent children
(one per line, please): |
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| How
did you first hear about American Indian
College? |
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Address of parent or nearest
relative (other than spouse) that AIC may notify in case of
emergency: |
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First Name:
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| Last
Name:
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Middle Name: |
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| Home
Phone: |
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| Cell
Phone: |
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| Address: |
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| City: |
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| State: |
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| Zip: |
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| Application Information |
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Application for: |
Fall 20
Spring 20
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Admission Status: |
Freshman
Transfer |
| I
plan to attend AIC: |
Full-time
Part-time |
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Are you seeking a degree from AIC? |
Yes
No |
| Which degree are
you interested in earning? |
Bachelor of Arts in Elementary Ed
Associate
of Arts in Business
Bachelor of
Arts in Christian Ministry
Associate of Arts in Christian Ministry |
Area of academic interest:
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Church Ministries
Christian Education and Youth Ministry
Intercultural Ministries
Bible |
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What is your career goal? |
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Please list 3 reasons
why you chose to apply to American Indian College: |
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1. |
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2. |
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3. |
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What other colleges or
universities are you considering applying to?
(Please list these institutions in the order of preference and
include AIC): |
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1. |
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2. |
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3. |
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4. |
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Educational
Background |
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High
School Diploma
GED
College/University |
| High School
Name: |
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| City: |
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| State: |
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| Date
Graduated: |
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| Date GED
Passed: |
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Other Schools and
Colleges or Universities attended: |
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Scholastic
Honors/Awards:
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Church
Information |
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Church Name: |
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Church Phone: |
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Address: |
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City: |
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State: |
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Zip: |
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Denomination: |
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Christian
Experience |
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How long have you
been a Christian? |
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Please give a brief
account of how you became a born-again Christian: |
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Do you feel the call
to some Christian ministry or service? Please explain: |
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Church/Pastor
Information |
| Name: |
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| Phone: |
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Title/Position: |
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| Church Name: |
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| Address: |
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| City: |
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| State/Country: |
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| Zip Code/
Country Code:
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Employment
& Experience Information |
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Non-church related: |
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Church related
(include all paid and volunteer positions, committees, services and
activities during the past five years): |
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Special
Consideration |
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Have you ever been
dismissed from school or placed on academic or disciplinary
probation? |
Yes
No |
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Do you have any
physical handicaps which might require special consideration from
the college? |
Yes
No |
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Have you ever used
tobacco, alcohol or illegal drugs? |
Yes
No |
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Have you ever
received professional care for emotional problems?
(If yes, please include name,
address & phone number of your caregiver in your explanation below.) |
Yes
No |
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Have you ever been
convicted of a crime? |
Yes
No |
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Have you ever been in
jail? |
Yes
No |
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If you checked
"yes" to any of the above, please explain below, including dates.
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Personal
Statement |
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Statement: My initials
below affirm that I am in agreement with the mission and purposes of
the American Indian College of the Assemblies of God. I certify that
the answers in this application are correct to the best of my
knowledge and belief. I understand that any failure to fully
disclose all required information may void my application. I further
understand that any subsequent determination of dishonesty in the
application will be grounds for dismissal from the college.
Date:
Initials:
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