Initiators Christian University 7901 4th St N Ste 300 St. Petersburg, FL 33702 Email: info@initiatorschristianuniversity.com APPLICATION FOR ADMISSION A Payment of $50 is required with submission. School Site:* City State Zip MAIL ALL APPLICATION FORMS TO: Admissions Office 7901 4th St N Ste 300 St. Petersburg, FL 33702 IMPORTANT: Applications will not be processed nor academic standing be assessed unless all questions are answered and the application signed and dated by applicant. Do not leave any question blank. Put .N/A. if an item, such as a FAX number or email address, does not apply. Personal InformationName* First Address* Street City State Zip AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Home Phone*Work Phone*CellEmail* Birthday*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Sex* Male Female Other SS# last 4 digits* Marital Status* Place of Birth* Race* Occupation* Citizen of what country* Emergency Contact* Phone*Church Background/Denomination* Church Presently Attending & Pastor* Emergency Contact* Relationship* Phone*MINISTRY EXPERIENCECurrent Ministry Status, if any: (Check one)* Senior Pastor Missionary Youth Minister Chaplin Church/Ministry Administrator Assistant Pastor Evangelist Children’s Ministry Music Minister Lay Minister Other Credentialing Organization* Are you currently licensed or ordained? (Check one)* Licensed Ordained N/A Past Ministry Involvement* # years in Ministry* EDUCATIONAL INFORMATIONCollege/Seminary/Graduate School* School Name Location Degree Received Year College/Seminary/Graduate School School Name Location Degree Received Year College/Seminary/Graduate School School Name Location Degree Received Year College/Seminary/Graduate School School Name Location Degree Received Year College/Seminary/Graduate School School Name Location Degree Received Year SALVATION TESTIMONYEDUCATIONAL & MINISTRY GOALSADDITIONAL INFORMATIONWHAT DEGREE/CERTIFICATE ARE YOU SEEKING* Certificate in Bible Teaching Certificate in Biblical Studies Certificate in Christian Leadership Certificate in Christian Ministry Certificate in Theology Certificate in Prayer & Spiritual Ministry Certificate in Evangelism and Church Planting Certificate in Leadership Development and Spiritual Formation Bachelor of Science Biblical Studies Degree Bachelor of Science in Theology Degree Bachelor Arts Degree in Ministry Degree Master of Science in Biblical Studies Degree Master of Arts in Ministry Degree Master of Divinity Degree Doctor of Theology Degree (THD) Doctor of Ministry (DMin) Non-Discrimination Policy: ICU does not discriminate on the basis of nationality, ethnic origin, age, or gender. We guarantee the rights and privileges, and the availability of programs and activities to all students of the College. Privacy Rights of Students: STATUTE 20, UNITED STATES CODE, 1232g and regulations adopted pursuant thereto. The code provides for an institution to establish a category of student information termed .directory information. All information, such as health and medical records, disciplinary records, records of personalcounseling, required student and family financial income information records, transcripts or student permanent academic records, student placement records and other personally identifiable information shall be open for inspection only to the student and such members of the professional staff of the college as have responsibility for working with the student. Such information will not be released to second parties without consent of the student. Except as required for use by the president in the discharge of his official responsibilities as prescribed by laws, regulations of the state board, and board policies, the designated custodian of such records may release information from these records to others only upon authorization in writing from the student or upon a subpoena by a court of competent jurisdiction. PLEASE READ CAREFULLY THE FOLLOWING AFFIDAVIT OF AGREEMENT BEFORE CHECKING THE I AGREE BUTTON* I Agree1. I certify that I have truthfully and accurately answered all questions contained in this application. I understand that falsification of any kind is grounds for refusal of my application or expulsion should falsehood be discovered after acceptance to the College. 2. I agree that I have been notified of my rights as recorded by STATUTE 20, UNITED STATES CODE 1232g. 3. I agree to abide by the policies of this institution as described in the Student Handbook and Course Catalog. 4. I understand that Initiators Christian University is accredited by National Bible College Association a private non-governmental agency and is not regionally accredited. Initiators Christian University has not sought U.S. Department of Education recognition at this time nor does Initiators Christian University guarantee the acceptance of academic credit by colleges and universities or other Bible schools. 5. I acknowledge that Initiators Christian University is not a job placement service and makes no claims regarding employment.Product NameTotal $0.00 To be paid via PayPal in the next screen to submit the application.