PRELIMINARY APPLICATION FORM Name, Last* First* Address City State Zip Main Phone Other Phone 1 Other Phone 2 Email* Date of Birth Date of first class (if decided or known) Have you accepted Christ as your Savior?YesNoNot Sure If so about when did you accept Christ as your Savior (approximate year is fine) BaptismYesNoNot Sure If so, about what year were you baptized? Name of Church you attend Church Address Which degree will you be be pursuing?An Institute Level degreeAn Associate of Arts degree (A.A.)A Bachelor’s degreeA Master of Ministry degree (or equivalent)A Master of Divinity degree (M.Div)A Doctor of Ministry degree (or equivalent)A PhD degree Educational Background (H.S., Colleges, Seminaries/ Degrees earned/ Date of graduation from each school). Please share with us why you are considering Antioch College or Antioch Seminary. How would you prefer that Antioch contact you? Please indicate your preferred way of contacting you and the information we will need to do so in the space provided here.By phoneBy cellphone textingBy WhatsAppBy email Any Information Antioch might need to contact you. Submit
