Full Name:
Date of Birth
Country of Origin
Social Security Number
Current Address:
City:
County
State
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Arkansas
California
Colorado
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Florida
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Louisiana
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Virginia
Washington
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Other
Zip
Telephone:
E-mail:
Leave the following address information blank if same as above.
Permanent Address:
City:
State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Dist. of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Other
Zip
Current Employment
Work Phone
Alternate Phone
Harding University is committed to the policy of providing equal opportunity for all persons and does not discriminate in admissions, programs, or any other educational functions and services on the basis of race, color, creed, national origin, sex, age, veteran status, religion or disability to those who meet its admission criteria and are willing to uphold its values as stated in the Code of Conduct.
Information gathered by this document is for internal use and in order to compile data required by our accrediting institutions which is reported in terms of generalized data without providing names or personalized details.
Are you Hispanic or Latino?
Yes
No
Select any of the following racial groups that apply to you
American Indian or Alaska native
Asian
Black or African American
Native Hawaiian or other Pacific Islander
White
Religious Preference
Current Church Membership
Current Ministry Involvement (if any)
Projected semester
of enrollment:
(example: Fall 2008)
How did you hear about the Masters of Ministry program?
In chronological order, list all schools attended since high school.
For each, include
Name of Institution,
Location,
From-To Dates,
Degree/Date Received
Institute 1:
Institute 2:
Institute 3:
Institute 4:
Concerning undergraduate Bible training please check all that apply:
Have had a least eight courses (16 hours minimum) in Bible.
Have had at least four courses (8 hours minimum) in the Bible text.
Have had a course in biblical interpretation (grade of B or better).
Have had a course in biblical language.
Have had an orientation course to biblical research (grade of B or better).
What is your undergraduate cumulative grade point average (GPA)?
Will you be transferring in graduate Bible hours?
Yes
No
Will you be taking courses online or at Harding?
Online
At Harding
Not sure
List any extracurricular and civic activities, organizations, or achievements.
List any significant life and ministry experiences you have had.
Has academic or disciplinary action been taken against you by any college or
professional organization?
Yes
No
If yes, explain:
Have you ever been convicted of a crime?
Yes
No
If yes, explain:
Have you ever been treated for alcohol/drug problems or had substance use
problems?
Yes
No
If yes, explain:
Do you know of any problem that might otherwise adversely affect your
admission to this program?
Yes
No
If yes, explain:
CONTACT INFORMATION
Father's name, if living
Address
City
State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Dist. of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Other
Zip
Phone numbers
Mother's name, if living
Address
City
State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Dist. of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Other
Zip
Phone numbers
Emergency contact name
Address
City
State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Dist. of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Other
Zip
Phone numbers
REFERENCES to whom you will be sending forms
Teacher name
Address
City
State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Dist. of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Other
Zip
Phone numbers
Elder/Church Leader
Address
City
State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Dist. of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Other
Zip
Phone numbers
Another Elder/Church Leader
Address
City
State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Dist. of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Other
Zip
Phone numbers
Check over all the information you have entered above for accuracy. Once you submit this form, you will be given a list of other documentation you must send by mail.