Rhema University Application

GENERAL INFORMATION

Referred By
First Name	Middle Name
Last Name
Street Address	Apt.#
City
State	Zip code (Postal code)
Country
Social Security #
Telephone (cell)
E-mail Address
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 Theology Bachelor of Christian Counseling Bachelor of Elem. Education
	Graduate Programs
	Masters of Ministry Masters of Theology Masters of Christian Counseling Doctor of Ministry Doctor of Theology Doctor of Christian Counseling

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