Application for Study
ALPHA INSTITUTE OF MINISTRY
Name: _________________________________________________________________________________
Street Address: __________________________________________________________________________
_______________________________________________________________________________________
Home Phone: ____________________________________________________________________________
Work Phone: _________________________________ Cell: _______________________________________
E-mail: __________________________________________________________________________________
Web site or Face Book: ____________________________________________________________________
Date of Birth (d/m/y) ______/_______/___________ Gender: F_____ M______
Country of Residence: _____________________________________________________________________
Area of Study
[ ] 1-Year Certificate in Christian Service
[ ] 2-Year Diploma in Christian Service & General Ministry
[ ] Advanced Qualification in Biblical Study
FINANCIAL AID
Do you seek Financial Aid? Yes No
Do you seek a Y.E.S. Grant or Loan? Yes No
Note: Alpha Institute of Ministry does not discriminate on the basis of race, color, sex, age, religion, marital status,
disability, national or ethnic origin, or socio-economic status.
EDUCATION:
What is your highest level of education? _______________________________________________________
List below the last schools attended:
SCHOOL LOCATION DATE QUALIFICATIONS
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
EMPLOYMENT EXPERIENCE: List last three positions: (Start with current)
DATES EMPLOYER/ADDRESS POSITION
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
REFERENCES: References are required as part of the admission process. Please give names and
complete addresses of references.
Professional/Education Reference:
________________________________________________________________________________________
________________________________________________________________________________________
Character Reference
________________________________________________________________________________________
________________________________________________________________________________________
____________________________________
Signature of Applicant
Remember to sign your printed application form. Submit $100 application fee and mail to:
Attn. Helen Desaine
Office of the Registrar
Alpha Institute of Ministry
LP#4 Bedessie Street
St Augustine, Trinidad & Tobago
