Eugene Bible College
APPLICATION FOR ADMISSION LEARN.GROW.LEAD

APPLICANT TYPE 
 
ENTRY YEAR 
 
ENTRY TERM 
   
 
ABOUT ME (SECTION 1 OF 5)

FIRST NAME 
 
MIDDLE NAME 
 
LAST NAME 
 
PREFERRED NAME 

BIRTH DATE 

PERMANENT ADDRESS 

CITY 
 
STATE 
 
ZIP 
 
COUNTRY 

HOME PHONE 
 
CELL PHONE 
 
EMAIL  

GENDER 
 
MARITAL STATUS 
 
CITIZENSHIP STATUS 
 
DESCRIBE YOUR HEALTH 
HAVE YOU EVER BEEN CONVICTED OF ANY CRIMINAL OFFENSE,
OTHER THAN A MINOR TRAFFIC VIOLATION?
 
  IF YES, PLEASE EXPLAIN AND PROVIDE DATES.
HAVE YOU EVER BEEN DENIED ADMISSION OR DISMISSED FROM
ANY COLLEGE FOR ACADEMIC OR DISCIPLINARY REASONS?

 
  IF YES, PLEASE EXPLAIN AND PROVIDE DATES.
HAVE YOU USED ALCOHOL, TOBACCO, OR NARCOTICS
WITHIN THE PAST YEAR?

 
  IF YES, PLEASE EXPLAIN AND PROVIDE DATES.
 
MY FAMILY (SECTION 2 OF 5)

SPOUSE'S FULL NAME AND AGE (IF APPLICABLE) 

NAMES OF CHILDREN AND AGES (IF APPLICABLE) 
FATHER OR LEGAL GUARDIAN      

FIRST NAME 
 
LAST NAME 
 
PHONE 
 
OCCUPATION 
 

COLLEGE 

PERMANENT ADDRESS 
 

CITY 
 
STATE 
 
ZIP 
 
COUNTRY 
 
MOTHER OR LEGAL GUARDIAN      
 

FIRST NAME 
 
LAST NAME 
 
PHONE 
 
OCCUPATION 
 

COLLEGE 

PERMANENT ADDRESS 
 

CITY 
 
STATE 
 
ZIP 
 
COUNTRY 
 
ARE YOUR PARENTS IN SUPPORT OF YOUR ATTENDANCE AT EUGENE BIBLE COLLEGE?
 
 
 
MY FAITH (SECTION 3 OF 5)

CHURCH YOU ATTEND 
 
DENOMINATION 
 
CHURCH CITY/STATE 
 
YEARS ATTENDED 
 

SENIOR PASTOR 
 
YOUTH PASTOR 
       
 
WHEN AND HOW DID YOU RECEIVE CHRIST AS YOUR PERSONAL LORD AND SAVIOR?
 
MY LIFE (SECTION 4 OF 5)

HIGH SCHOOL NAME 
 
H.S CITY/STATE 
 
H.S. GRADUATION YEAR 
 
APPROXIMATE GPA 
 

HAVE YOU BEEN HOME SCHOOLED? 
 
DID YOU RECEIVE A GED? 
     
 
BELOW PLEASE LIST THE COLLEGES YOU HAVE ATTENDED
 
INSTITUTION NAME   DEGREE COMPLETED   CITY/STATE/COUNTRY   DATES ATTENDED
     
     
     
     
 
TO WHAT OTHER COLLEGES OR UNIVERSITIES ARE YOU SEEKING ADMISSION?
 

HOW DID YOU FIRST HEAR ABOUT EUGENE BIBLE COLLEGE? 
 
IF OTHER, ENTER HERE
   
WHAT INFLUENCED YOU TO APPLY TO EUGENE BIBLE COLLEGE? (SELECT ALL THAT APPLY)    
 
DESIRE TO GO INTO MINISTRY   LOCATION   PROGRAM OFFERINGS   SPIRITUAL BELIEFS
COLLEGE OFFERINGS   TUITION COST   BIBLE CERTIFICATE   OTHER   
I PLAN TO LIVE IN COLLEGE HOUSING
 
  IF NO, PLEASE EXPLAIN
 
(PLEASE NOTE: ALL SINGLE STUDENTS ENROLLED FOR MORE THAN 6 CREDIT HOURS WHO ARE UNDER AGE 21 ARE REQUIRED TO LIVE IN COLLEGE DORMITORIES UNLESS LIVING WITH PARENTS OR IMMEDIATE RELATIVES. STUDENTS UNDER AGE 21 MAY APPLY TO LIVE OFF CAMPUS BY FILING A PETITION WITH THE STUDENT DEVELOPMENT OFFICE.)
 
WHICH PROGRAM DO YOU PLAN TO COMPLETE AT EUGENE BIBLE COLLEGE?
 
       
 
THE END (SECTION 5 OF 5)
  • DON'T FORGET TO GO BACK OVER THE APPLICATION INSTRUCTIONS TO MAKE SURE YOU HAVEN'T MISSED A STEP.
  • READ THE CODE OF CONDUCT INCLUDED IN THE APPLICATION BEFORE YOU AGREE TO THE TERMS BELOW.
  • FINALLY, SEND IT IN AND JUST RELAX!

BY SUBMITTING THIS APPLICATION, I CERTIFY UPON MY HONOR THAT THE ANSWERS AND INFORMATION SUBMITTED IN THIS APPLICATION ARE TRUE AND TO THE BEST OF MY KNOWLEDGE. IF ADMITTED TO EUGENE BIBLE COLLEGE, I WILL PRAYERFULLY UNDERTAKE A COURSE OF STUDY IN THE COLLEGE AND DEVOTE MY BEST EFFORTS TO IT. I WILL CHEERFULLY ABIDE BY THE SPIRIT AS WELL AS THE CODE OF CONDUCT OF THE COLLEGE AND WILL WORK AT ALL TIMES IN HARMONY WITH THE ADMINISTRATION, FACULTY, AND STUDENTS. I HEREBY PLEDGE MY ALLEGIANCE TO THE WORD OF GOD AND CAUSE OF JESUS CHRIST, PROMISING TO BE FAITHFUL TO ALL TASKS SET BEFORE ME.