Application form - PATS Education

Application for Admission

Application Fee: $50 – Non-refundable

Applicaiton for Admission

First Name

Middle Name

Last Name

Address

Address Line 1

Address Line 2

City

State

Zip Code

Country

Office Phone

Home Phone

Date of Birth

Marital Status

Number of Children

Church Affiliation

Social Security Number

Parent's Name

Address

Previous Education (include High School)

Previous Education (include College)

Life –Work Experience in the Field of the Degree Being Sought

Please give two names (not relatives) with addresses, for reference:

Degree you wish to pursue first:

Agreement

Should I be accepted, I agree to give cheerful obedience and cooperation to the regulations of the institutions. I understand that degrees earned through Phillips Theological Seminary are for Christian service in the work of the Lord, and that the School is not controlled by the Pennsylvania State Department of Higher Education.

Signature

PATS Education

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