When do you plan to begin at CMC? ---Fall 2019Spring 2020Fall 2020
Social Security Number (if none, type "none")
Enrollment Status ---New StudentTransfer StudentPrevious LABI Student
Residency Status ---On-CampusCommuter
Date of Birth (mm/dd/yyyy)
Are you a U.S. Citizen? ---YesNo
If no, what is your Visa Status?
Country of Citizenship
Are you a Veteran? YesNo
Are you receiving any VA Benefits? YesNo
Type of Benefits
Address Line 1
Address Line 2
Facebook Page? ---YesNo
Marital Status ---SingleMarriedSeparatedDivorcedRemarried
If married, give name of spouse
Please list names of children and their ages
What program do you desire to join? B.S. in Church MinistriesA.A. in Church MinistriesCertificate (Credential Track)
Relationship ---HusbandWifeFatherMotherLegal GuardianAuntUncleSisterBrotherCousin
Last High School Attended (Name of School)
Date of High School Diploma (mm/dd/yyyy)
Date of GED (mm/dd/yyyy)
Have you been on academic or disciplinary suspension from any college? YesNo
List each College/University you have attended (An official transcript must be sent to CMC before you enroll)
How long have you been a Christian?
Have you been baptized in water by immersion (Mark 16:16)? YesNo
Have you received the baptism of the Holy Spirit according to Acts 2? YesNo
If no are you earnestly seeking Him? YesNo
Have you used tobacco, drugs, alcohol or any illegal drugs or mind-altering substance or struggled with pornography, homosexuality or sexual promiscuity within the last five years? YesNo
If Yes, state which and give date of discontinuance.
Have you ever been convicted of a felony? YesNo
If yes, please explain and give dates.
What Church are you attending?
If A/G, what district
I approve of the high moral standards of CMC and agree to abide by its policies. (If you agree, please enter your initials or the last four numbers of your social security number to confirm your signature.)