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July 04, 2008
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First Name:
Last Name:
Middle Initial:
Nickname:
Home Address:
Address (cont.):
City:
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Country:
Work Phone:
Home Phone:
Fax Number:
Email Address:
Date of birth:
Sex:
Female
Male
Choose one of the following options:
Married
Separated
Single
Remarried
How did you hear about IISOM:
What degree do you wish to obtain:
Personal References:
Please list three (3) Personal References. One must be a Minister. Give Name, Address and Phone Number.
What is your highest high school grade completed:
College / Degrees:
List amount and name of college if any. List degrees earned as well.
Completed High School?:
No
Yes
Special Training, Additional Education or Degrees:
Do you feel a definite call to the full-time ministry?:
No
Yes
If yes, to what type of ministry do you feel called?:
List Christian services in which you have been involved:
Please write an autobiographical sketch:
Include the following: Your Christian Experience. Past or present experiences that have significantly influenced your life. A statement on why you desire to attend IISOM. *350 words
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