Certificate
Application for Admission

1. PERSONAL INFORMATION

First Name: 
Middle Initial: 
Last Name: 
Address: 
City: 
State: 
Zip Code: 
Email: 

Home Phone: 
Cell Phone: 
City/State of Birth: 
Date of Birth: 
Gender: 
Marital Status: 
Spouse's Name (If Applicable):
Occupation/Profession: 

2. PREVIOUS ACADEMIC EXPERIENCE

Highest level of education achieved: Check one box below. 

3. CHURCH BACKGROUND

Name of the church you presently attend: 
Denomination: 
Church Address: 
Church City: 
Church State: 
Pastor's Name: 
Pastor's Email: 
Please note an email will be sent to your pastor for recommendation.

4. SPIRITUAL EXPERIENCE

Please give a brief description of your salvation experience: 
Why do you want to study in INSTE? 

5. SIGNATURE

Signature: 
Date:   

By typing my name in the signature box above, I am affirming that everything on this form is accurate and truthful.