Student's Name *

First Name

Last Name

Student Mobile Phone

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Parent's Name

First Name

Last Name

Parent Mobile Phone

(###)

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Home Phone

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Desired Program

Share your potential Ambassador program of interest:

Associate Degree in Christian Ministry

Associate Degree in Biblical Studies

One-Year Certificate in Biblical Studies

Taking individual courses for credit / audit

Not sure

Next Steps

Please select all that apply:

Please send me more information about Ambassador.

I would like to speak with an admissions representative.

I am interested in an upcoming Ambassador Visit Day.

I am interested in a personalized campus visit.