Aenon Admissions

Email address

Today's Date

Registrant Basic Information

Prefix (Bishop, Suffragan Bishop, District Elder, Elder, Minister, Rev., Dr. Etc.)

First Name

OPTIONAL: Middle Name

Last Name

Gender

Date of Birth

Last 4 of Social Security/ID Number

Phone Number (only numbers)

Do you have any medical conditions we should be aware of that may impact your ability to be successful at Aenon?

Are you seeking or require an accommodation for a disability under the Americans with Disabilities Act (ADA)?

Registrant Address

Address

City

State

Zipcode

Country

Ministry Information

Present Position in Church

Select Your Council ('00 - Other' if not with PAW)

Enter your License Number

OPTIONAL: Highest Level Education Completed

OPTIONAL: Other Courses/Training Completed

Church Information

Pastor Name

OPTIONAL: Pastor/Church Email Address

OPTIONAL: Pastor/Church Phone Number

Home Church Name

Church Address

Church City

Church State

Church Zip Code

REQUIREMENTS FOR ADMISSIONS

Declaration and Signature

I certify, of sound mind and judgement, the information provided is accurate and complete. I understand that this application does not guarantee admission. I agree to abide by the spiritual, academic, and behavioral policies of Aeron Bible College if accepted.

Admissions: