The American Institute of Theology

Office of Admissions
P.O. Box 1021
Harrison, Arkansas 72602

BIBLE CORRESPONDENCE COURSE APPLICATION

STUDENT ENROLLMENT NON-STUDENT PARTICIPATION

Please print these pages and type or print in space provided. All information received by the Institute will be held in strict confidence.

NAME (Mr., Mrs., Miss) __________________________________________________

MAIDEN / FORMER NAME (If Any) _______________________________________

ADDRESS ______________________________________________________________

CITY_____________________________ STATE________________ ZIP___________

PHONE NUMBER _______________________________________________________

EMAIL ADDRESS _______________________________________________________

DATE OF BIRTH ________________________________________________________

MARITAL STATUS: Single Married Divorced Widowed

RACIAL-ETHNIC HERITAGE (English; German; Irish; Scottish; etc. -- Specify all categories that apply) ________________________________________________________________________

________________________________________________________________________

 SCHOOL LAST ATTENDED _______________________________________________

If not a high school graduate, have you completed an equivalency program (GED)?
Yes No

LIST DEGREE(S) and CERTIFICATES EARNED ______________________________

CHURCH AFFILIATION ___________________________________________________

OCCUPATION ____________________________________________________________

HOBBIES and INTERESTS _________________________________________________

_________________________________________________________________________

ASSOCIATIONS You Belong To _____________________________________________

_________________________________________________________________________

How did you hear of A.I.T. ? _________________________________________________

What will you do with your increased knowledge of the Holy Scriptures? _____________

_________________________________________________________________________

You May indicate here any additional goals, strengths, weaknesses, achievements, or other comments you have _______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

I am enrolling as a Student and paying for the course in installments ($68.00 for registration and $11.00 per lesson).

I am enrolling as a Student and paying for the course in advance ($200.00). The extra supplemental books are included at no additional charge.

I would like my lessons sent Priority Mail ($5.00 per lesson, $60.00 total)

[Extra postage to cover costs will also be added for foreign students]

I am participating as a Non-Student; Please send the Bible Course as a Reference Work ($75.00 without extras). $100.00 with extras.

Please send the following educational materials for which I'm enclosing $________:

_______________________________________________________________________

I'm making a donation of $_________ to help promote the Christian educational goals of the Institute.

Total Amount Enclosed $___________ Cash Check Money Order Silver
Other ___________

I certify that the information given is complete and accurate to the best of my knowledge. I understand that giving false information is grounds for denial of admission, or immediate suspension if enrolled.

Signature of Applicant _________________________________ Date ______________

Please attach a photo of yourself. (Optional)

HOMEGO BACK