uscia-student-application | Rhema University

Rhema University & U.S.C.I.A

Partnership Student Application

Rhema University & U.S.C.I.A

Partnership Student Application

U.S.C.I.A Badge Number

Name *

First

Middle

Last

Address *

First

Middle

Last

Country *

First

Last

Social Security #

Telephone *

Email *

Gender *

Place of Birth *

First

Middle

Last

Citizenship *

Date of Birth *

First

Last

Marital Status *

Spouse Name

Do you Plan to Attend *

Undergraduate Programs

Bachelor Program "Will receive a USCIA special Scholarship"

Bachelor of Ministry
Bachelor of Christian Counseling

Graduate Programs

Previous Education Information

First

Middle

Last

First

Middle

Last

First

Middle

Last

Are You Ordained

If Ordained Select Title

Name on Debit/Credit Card *

For this Dual Chaplaincy Certificate with Rhema University and USCIA logos presented on the certificate, your card will be charged a $475 tuition fee.

Type Of Card *

Card Number *

3 Digit CSC ( On Back of Card ) *

Expiration Month *

Expiration Year *

Place Your Name Here As Your Signature *

First

Last

I have read this online 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 online presentation. I understand that all information given in this application is subject tox verification and will be confidential.

Rhema University & U.S.C.I.A

Partnership Student Application

Rhema University & U.S.C.I.A

Partnership Student Application

Teaching followers to become

Leaders.