* Last Name :
* First :
Middle :
* Gender :
M
F
* Social Security Number :
* Home Address :
* Present Address :
* Birthdate :
Jan.
Feb.
Mar.
Apr.
May
June
July
Aug.
Sept.
Oct.
Nov.
Dec.
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
* Birthplace (City) :
* State :
* Email :
* Phone :
Cell Phone :
* Citizen of :
USA
Other
Country (if OTHER) :
If OTHER, give type of resident :
Student Visa
Permanent Visa
Other
Check here if you are a resident alien .
(Please send a copy of your resident alien card.)
* Church Name :
* Denomination :
* Church Address :
* Pastor's Name :
* Phone :
* Have you accepted Christ as your personal Savior?
Yes
No
* Are you a member of a local church?
Yes
No
* Are you essentially in agreement with the doctrinal statement of the College?
Y
N
If no, please indicate the area:
FAMILY (If you are a married or independent student this section is optional.)
Father's full Name :
Living?
Yes
No
Occupation :
Address :
Phone :
Mother's full Name :
Living?
Yes
No
Occupation :
Address :
Phone :
If parents are divorced or separated, with whom do you live?
Father
Mother
Other
Children in family other than yourself : Brothers?
Yes
No
Sisters?
Yes
No
Has any relative attended LBC?
Yes
No
Relationship:
When?
EDUCATIONAL DATA
* Your purpose in wanting to attend LBC :
* Plan to enroll : Year
Semester :
Fall
Spring
* Status :
Full Time
Part Time
Commuter
Resident
* Degree/Certificate :
Bachelor Of Science
Associates Degree in Science
One Year Certificate
* Desired Area of Study :
Note: If you are uncertain as to which program to select, please choose either "Undecided" OR the program of most interest to you. Assistance will be provided by the College as you continue in the application process.
BIBLICAL COUNSELING DEPT.
Professional Counseling Program
Social Work Program
CHURCH AND MINISTRY LEADERSHIP
Children and Family Ministry Program
Christian Ed. and Discipleship Program
Church Planting Program
Pastoral Ministry Program
Women in Christian Ministries Program
Youth Ministry
HEALTH, PHYSICAL EDUCATION
Health and Physical Education Program
Sports Management/Ministry: Administration & Coaching
Sports Management/Ministry: Wilderness Camping and Management
INTERCULTURAL STUDIES DEPARTMENT
Cross-Cultural Ministry
Teaching English Speakers of Other Languages
MUSIC DEPARTMENT
Church Music Program
Music Ministries Program
Music Education Program
OFFICE ADMINISTRATION DEPARTMENT
Office Proced. and Tech (A.S.)
TEACHER EDUCATION DEPARTMENT
Bible Education Program
Early Childhood Education
Elementary Education
Guidance Counselor/Bible Education
Teacher Certification (for those who already have a B.S. degree)
SPECIAL A.S. or B.S. PROGRAMS
Assoc. Degree in Bible - Two Year
Bible Ministries (A.S.) - Two Year
Bible Ministries (B.S.) - Four Year
ONE YEAR CERTIFICATE PROGRAMS
Concentrated Bible Course
LBC Certificate Program
UNDECIDED
* High School Name and Address :
* HS Graduation Date (month/year):
Jan
Feb
March
April
May
June
July
Aug
Sept
Oct
Nov
Dec
* Course of Study:
Academic
Business
General
Vocational
List all colleges, universities, and community colleges attended (include dates and any degrees received) :
Please request the institutions listed above to send official transcripts.
* Have you ever been dismissed or placed on probation? (If yes, please give a description in a separate email to admissions@lbc.edu)
Academic
Yes
No
Disciplinary
Yes
No
Have you applied, or are you applying for admission to any other college?
Yes
No
If yes, where?
(optional question, for record keeping)
* Who influenced you the most to consider LBC?
Parent
LBC Student
LBC Alum
LBC Faculty
Pastor
High School Teacher
Other
ACTIVITIES (This section is used to determine eligibility for scholarships.)
Varsity Sports in which you participated . (Put the number of years involved after each sport.)
Captaincy, letter earned, or awards ?
Yes
No
Are you planning to participate in LBC's athletic program ?
Yes
No
If yes, which sports are you interested in playing:
Men's
Basketball
Baseball
Soccer
Cross-Country
Volleyball
Women's
Basketball
Cross-Country
Soccer
Volleyball
Musical Activities in which you participated : (Put the number of years involved after each activity.)
Do you plan to participate in LBC's music program ?
Yes
No
If yes, name the activities:
Conestogans (chorale)
Handbells
Concert Band
Flute Ensemble
String Ensemble
Community Orchestra
Do you play a musical instrument ?
Yes
No
If yes, what instrument?
Other School Activities in which you participated : (Put the number of years after each.)
Debating
Drama
Magazine
Newspaper
Student Government
Yearbook
Other:
Church Activities in which you participated :
Community Activities in which you participated :
Honors/Awards/Leadership :
FINANCES
How do you plan to finance your first year in college ?
Savings
Parents
Grants/Loans
Part-Time Work
Other
Are you eligible for any benefits ?
Social Security
Veterans Administration
OVR
Other
Have you filed the Free Application for Federal Student Aid (FAFSA) ?
Yes Date:
No (See instructions in LBC catalog)
LIFESTYLE STANDARDS
* Have you used tobacco, alcohol, or drugs in the past ?
Yes
No
If yes, explain :
Please NOTE: During enrollment at the College, students must abide by the standards outlined in the Student Handbook. Students are required to abstain from the use of tobacco, alcohol and drugs.
PERSONAL TESTIMONY
The following questions are used to gather an autobiographical statement from you. Your autobiography will help us get to know you and also evaluate your writing skills. Please answer each question in paragraph form with a minimum 4 sentences each.
* Please tell us a little about yourself (include family background, school/employment experience, church/community involvement) :
* Please tell us how you came to know Christ as your Savior (a clear salvation experience), and a little about your walk with the Lord :
* I certify that all statements I have made on this form are complete and true .
* Name:
* Date: