ALASKA BIBLE INSTITUTE APPLICATION FOR ADMISSION/RE-ADMISSION

(1)

ALASKA BIBLE INSTITUTE

APPLICATION FOR ADMISSION/RE-ADMISSION

Alaska Bible Institute exists to train & equip Christians for life and ministry. We are excited that you are considering us for the next step in your walk with Jesus.

INSTRUCTIONS FOR ENROLLMENT

Step One:

Complete this application if you: 1. are at least 18 years of age.

2. have graduated from High School or possess an equivalent certificate. 3. have read and agree to ABI’s rules set out in the Student Handbook.

4. are capable of paying the room and board fees associated with attending ABI. 5. are a returning student after three years absence.

The application can be completed and submitted by email, fax, mail, or in person at the ABI Main Office located in Homer, Alaska. Download this application and complete all necessary information. The application can be emailed to Admissions@AlaskaBible.org. Receipt of all electronically submitted applications will be promptly acknowledged. If a response is not received, please contact us at +1 907 235 8648. A non-refundable $25 processing fee is due upon receipt of the application. This fee can be paid by check or money order to:

Alaska Bible Institute c/o Admissions Department 1295 Mission Rd.

Homer, Alaska 99603 You can also pay this fee online at www.AlaskaBible.org/Payments.

International students should review the “International Students Admission Requirements” before applying for admission. The requirements are located online at www.AlaskaBible.org/Admissions.

Step Two:

Send the attached Pastoral and Personal Reference Forms to the individuals who will be filling these out for you. The individuals filling out the Reference Forms must be the ones to submit them to ABI. Reference Forms can be submitted by email, fax, mail, or in person at the ABI Main Office located in Homer, Alaska. The Reference Forms can be emailed to Admissions@AlaskaBible.org. Receipt of all electronically submitted references will be promptly acknowledged. Step Three:

Once all forms and references have been received our Admissions Director will contact you and conduct a phone interview. During this time your application will be under review. Once all necessary information is received it will take between 7-10 days for a decision to be made. Our Admissions Director will contact you as soon as a decision is made. Step Four:

Upon acceptance into our program you will be sent a ‘Welcome’ packet. This packet will contain all the information you need to attend ABI. It will also provide you with suggested supply list for moving to Alaska.

(2)

!

1/5!

GENERAL INFORMATION

Name:

Last First Middle Initial

Mailing Address:

Street / PO # City State/Providence Postal Code Country Physical Address:

If different from above. Street City State/Providence Postal Code Country Primary Phone #: Sex:

!

Male

!

_Female Date of Birth:

/ /

Include country/area code. Day / Month / Year

Email Address:

Do you have a valid Driver’s License?

!

No

!

_Yes: License #:

State: Marital Status:

!

Single

!

Engaged

!

_Married

Names & Ages of Children:

Have you served in the military?

!

No

!

Yes, branch

:

Dates: Reason/Type of Discharge:

Parents Names:

Primary Mailing Address:

Street / PO # City State/Providence Postal Code Country Primary Physical Address:

If different from above. Street City State/Providence Postal Code Country

Primary Phone #: Are your parents Christians?

!

No

!

Yes

Include country/area code.

(3)

!

2/5!

EDUCATION HISTORY

Are you a high school graduate?

!

No

!

Yes,date of graduation: If not, did you receive a GED?

!

No

!

Yes, when:

List below any colleges or post-secondary schools you have attended, and any degrees that you have received.

School Dates Degrees

1. !_No!_Yes:

2. !_No!_Yes:

3. !_No!_Yes:

OCCUPATION HISTORY

List below your previous work experience for the past 3 years and the type of work that you did.

Employer Dates Work Description

1. 2. 3.

List any special occupational or professional skills that you have. 1.

2. 3.

FINANCIAL

How do you plan to pay ABI’s Room & Board fees? !_{Own Employment}!_Savings!_{Spouse’s Employment} ! Other, explain:

Do you have any debts? !_No!_{Yes, what is the current monthly payment:}

HEALTH & LIFESTYLE

Have you had medical treatment for any disease, serious illness, injury, or disability within the past 3 years? ! No !_{Yes, please explain:}

Are there any significant physical or learning disabilities that we should be aware of? ! No !_{Yes, please explain:}

Do you have any dietary needs? ! No !_{Yes, please explain:}

(4)

!

3/5!

HEALTH & LIFESTYLE

CONTINUED

How would you describe your general health? ! Excellent ! Good ! Fair ! Poor Have you ever used tobacco? !_No!_{Yes. If you’ve quit, date of abstinence:}

Have you ever used alcohol? ! No ! Yes. If you’ve quit, date of abstinence: Have you ever used marijuana? !_No!_{Yes. If you’ve quit, date of abstinence:} Have you ever used any other illegal drugs or narcotics? ! No ! Yes, explain: Have you ever been convicted of a felony? !_No!_{Yes, explain:}

Students who attend Alaska Bible Institute are required to abstain from the use of alcohol, tobacco, marijuana, illegal drugs and narcotics, along with any immoral or unethical behaviour during their time. For a full list of rules please read the Student Handbook found at www.AlaskaBible.org. Your signature below indicates that you agree to abide by these standards while you are a student at Alaska Bible Institute.

Signature Date

CHURCH AFFILIATION

Name of the church presently attending:

Church Website: Church Phone #:

Church Mailing Address:

Street / PO # City State/Providence Postal Code Country

Pastor’s Name: How long have you attended this church?

How were you involved in the ministry of this church?

(5)

!

4/5!

CHRISTIAN EXPERIENCE

Briefly describe your current relationship with Jesus:

What is the most significant change God has worked in your life since you were saved?

Do you believe you have a calling on your life to enter into vocational Christian service? !_No!_Yes

If yes, in what area(s) of ministry?

REFERENCE INFORMATION

Ministry Reference

The Ministry Reference form should be filled out by someone who knows you well, such as your Pastor, Youth Leader, Elder, Ministry Leaders, etc.

Name: Primary Phone #:

Include country/area code. Mailing Address:

Street / PO # City State/Providence Postal Code Country Email Address:

Personal Reference

Someone who knows you well, such as an employer, teacher, or friend, should fill out the Personal Reference form.

Street / PO # City State/Providence Postal Code Country Email Address:

(6)

!

5/5!

EXPECTATIONS

Why do you want to attend Alaska Bible Institute?

How did you hear about us?

Are you planning to complete the two-year Biblical Studies Program? !_Yes!_Unsure

Are you planning to complete the three-year Christian Ministry Program? !_Yes!_Unsure

In order to keep student costs low, we require that all students assist in cleaning and maintaining the campus and facilities throughout the school year.

Do you agree to abide by this policy? !_No!_Yes

Have you read the Student Handbook? !_No!_Yes

Do you agree to abide by the regulations laid out in the handbook? !_No!_Yes

CERTIFICATION

By signing below I certify that all the information included in this application is complete and accurate to the best of my knowledge. I agree to abide by the spirit, rules, and schedule of the ABI program. I also confirm that I am fully aware of my financial obligations and agree to meet in a timely manner, prior to the completion of school, all room and board fees along with any other expenses incurred during my involvement with ABI. Finally, I understand that by signing this form I am giving ABI permission to contact my previously stated references as it pertains to character, personality, work habits, abilities, along with other general observations about me.

Signature Date

This application can be submitted by email, fax, mail, or in person at the ABI Main Office located in Homer, Alaska. The application can be emailed to Admissions@AlaskaBible.org. Receipt of all electronically submitted applications will be promptly acknowledged. If a response is not received, please contact us at +1 907 235 8648. A non-refundable $25 processing fee is due upon receipt of the application. This fee can be paid by check or money order to:

Homer, Alaska 99603 You can also pay this fee online at www.AlaskaBible.org/Payments.

LEGAL: ABI is an affiliate institution of the Association for Biblical Higher Education (ABHE) and as such it participates in and contributes to collegial and professional development activities of the Association. Affiliate status does not, however, constitute, imply, or presume ABHE accreditation status at present or in the future. ABI is a program that does not result in awarding of a degree, and that is sponsored by and conducted solely for the membership of a bona fide religious organization. ABI is tax-exempt under 26 U.S.C. 501(c)(3) as a religious organization and which offers and provides postsecondary education solely in the form of religious training to persons who hold or seek to learn the particular religious faith or belief of that religious organization.

Attach a recent photo here or attach in an email.

(7)

ALASKA BIBLE INSTITUTE

MEDICAL RELEASE

Name:

Last First Middle Initial

Mailing Address:

Physical Address:

If different from above. Street City State/Providence Postal Code Country

Primary Phone #: Sex:

!

_Male

!

_Female Date of Birth:

/ /

Include country/area code. Day / Month / Year

Email Address:

CONSENT FOR MEDICAL TREATMENT

Insurance Company:

Policy #:

Name of Policy Holder:

I hereby grant permission to Alaska Bible Institute or an attending physician to render to me any emergency treatment, hospitalization, and medical or surgical care that might be deemed necessary.

Signature Date

EMERGENCY CONTACT INFO

In case of emergency please contact:

Name: Relationship to Applicant

Primary Phone #: Email Address:

I hereby release Alaska Bible Institute, it’s parent organization, staff or volunteers from any liability whatsoever arising out of any injury, damage, or loss, which may be sustained by said person during the course of involvement with this institute.

(8)

ALASKA BIBLE INSTITUTE

REQUIRED MENINGITIS FORM

IMPORTANT NOTICE:

Information in this handout has been gathered from the Alaska Postsecondary Student Immunization Act (HB185), signed into law effective May 18, 2005. Additional information was gathered from the Alaska Department of Health and Social Services' Division of Public Health and the Web site of the American College Health Association at http://www.acha.org/projects_programs/meningitis. The Alaska Commission on Postsecondary Education (ACPE) cannot provide medical information and is not responsible for any medical information provided to schools or to students. For questions specific to meningitis, immunization, and related diseases, please consult a qualified medical professional.

DID YOU KNOW?

Meningococcal disease is a contagious but largely preventable bacterial infection that most often leads to meningitis, an inflammation of the membranes surrounding the brain and spinal cord, or a condition called meningococcal septicemia, which is an infection of the blood.

Meningococcal disease is caused by bacteria called Neisseria meningitidis that are spread person-to-person through the air (usually by sneezing or coughing), through direct contact with an infected person, such as oral contact with shared items like cigarettes or drinking glasses, or through intimate contact, such as kissing. This disease is not as contagious as things like the common cold or the flu, and it is not spread by casual contact or by simply breathing the air where a person with meningitis has been.

Meningococcal disease is a serious illness that can lead to death within a few hours of onset; one out of ten cases is fatal, and in one out of seven survivors it can lead to severe and permanent disabilities, such as brain damage, hearing loss, seizures, or limb amputation.

WHAT ARE THE SYMPTOMS OF MENINGOCOCCAL DISEASE?

High fever, headache, and stiff neck are common symptoms of meningitis in anyone over the age of 2 years. A rash may also develop over parts of the body, or the entire body. Other symptoms include nausea, vomiting, discomfort looking into bright lights, confusion, and sleepiness. These symptoms can develop over several hours, or they may take 1 to 2 days. As the disease progresses, seizures may develop. If you notice these symptoms – in yourself, friends, or others – you should contact your college health service or local hospital immediately.

WHO IS AT RISK FOR MENINGOCOCCAL DISEASE?

Anyone can get meningococcal meningitis, but scientific evidence suggests that college freshmen living in campus housing are at moderately increased risk to get this disease when compared to the general college population. The reasons for this increased risk are still not known for certain, Alaska Bible Institute but factors may include such things as crowded living situations, bar patronage, active or passive smoking, irregular sleep patterns, and sharing personal items. Other risk groups include infants and young children, household contacts to a person with meningococcal disease, refugees from parts of the world with high rates of meningococcal disease, laboratory workers who work with this bacteria, and military recruits.

(9)

ARE THERE VACCINES AGAINST MENINGOCOCCAL DISEASE?

Yes, there are two safe and effective vaccines that protect against four strains of the bacteria that cause meningococcal disease—serogroups A, C, Y, and W135. Immunization against meningococcal disease will decrease the risk of contracting the illness from these meningococcal strains.

HOW CAN MENINGOCOCCAL DISEASE BE PREVENTED?

Many cases of meningococcal disease can be prevented. The Centers for Disease Control and Prevention and the American College Health Association recommend that all first-year students living in residence halls be vaccinated against meningococcal disease. All other college students under the age of 25 years who wish to reduce their risk for the disease may choose to be vaccinated.

Vaccination is safe and effective. It protects against four of the five most common strains (or types) of bacteria that cause meningitis. Approximately 70 to 80 percent of cases in the college age group are caused by strains that are potentially vaccine-preventable. The most commonly reported adverse reactions among adolescents and adults in clinical studies were pain at the injection site, headache, and fatigue. These respond to simple measures (ibuprofen or acetaminophen) and resolve spontaneously within a few days.

FOR MORE INFORMATION

To learn more about meningitis and immunization, visit the websites of the American College Health Association, www.acha.org/meningitis, and the Centers for Disease Control and Prevention,

www.cdc.gov/ncidod/diseases/submenus/sub_meningitis.htm.

Vaccination is safe and effective. It protects against four of the five most common strains (or types) of bacteria that cause meningitis. Approximately 70 to 80 percent of cases in the college age group are caused by strains that are potentially vaccine-preventable. The most commonly reported adverse reactions among adolescents and adults in clinical studies were pain at the injection site, headache, and fatigue. These respond to simple measures (ibuprofen or acetaminophen) and resolve spontaneously within a few days.

I have received a copy of this notice on meningococcal disease. ! No ! Yes I have received an immunization against meningococcal disease. !_No!_Yes

Applicant Name

(10)

ALASKA BIBLE INSTITUTE

PASTORAL REFERENCE FORM

APPLICANT: PLEASE FILL IN YOUR INFORMATION BELOW THEN SIGN AND GIVE, WITH A STAMPED ENVELOPE, TO YOUR PASTOR. THANK YOU!

Applicant Name:

Last First Middle Initial I, the above named applicant, waive any right I have to read or obtain copies of this recommendation, knowing that this waiver is not required as a condition for admissions.

Signature Date

BELOW THIS LINE IS TO BE FILLED OUT BY THE PASTORAL REFERENCE.

The above applicant has applied for admission to Alaska Bible Institute (ABI). Founded in 1965, ABI exists to train and equip Christians for Life and ministry. We thank you for taking the time to fill out this reference form. We greatly encourage and welcome candid responses to the following questions, as this will allow us to make the best decision for the applicant. All information will be held in strict confidence. Your prompt attention in completing this form (within 7 days) is appreciated for the applicant to continue the admission process.

This form can be completed and submitted by email, fax, mail, or in person at the ABI Main Office located in Homer, Alaska. Download this form and complete all necessary information. This form can be emailed to

Admissions@AlaskaBible.org or mailed to:

Homer, Alaska 99603

Receipt of all electronically submitted reference forms will be promptly acknowledged. If a response is not received, please contact us at +1 907 235 8648.

(11)

!

1/2!

REFERENCE INFORMATION

Email Address:

Occupation: Relationship to Applicant:

How well do you know the applicant?

!

Very Well

!

Well

!

_Casual

How long have you known the applicant? Comments:

How well are you acquainted with the applicant’s religious/spiritual life?

!

Very Well

!

Well

!

Casual

Comments:

APPLICANT INFORMATION

Do you believe the applicant is genuinely converted?

!

No

!

Yes

What best describes the applicant’s conversion?

!

Mature

!

Genuine and Growing

!

Emotional

!

Superficial

Comments:

To what extent is the applicant active in church ministry?

With reference to their service, the applicant is:

!

Dedicated

!

Average

!

Casual

!

_Poor

Comments:

Does he/she display high moral standards?

!

No

!

_Yes

Comments:

Evaluate the applicant’s character in the following areas: Strongly Agree Agree Disagree Strongly Disagree

Exercises discretion in relationships:

!

Financially responsible:

!

Dependable:

!

Exhibits academic abilities:

!

Works well with others:

!

Capable of leading others:

!

Cares about cleanliness and hygiene:

!

Considers and prefers others:

!

Respectfully submits to authorities:

!

Self-Disciplined:

!

Demonstrates a positive self-image:

!

(12)

!

2/2!

Overall, what do you consider to be the applicant’s strong points? (Include special abilities) What could ABI do to aid the applicant’s personal development?

Briefly describe any physical limitations the applicant may have:

To your knowledge does the applicant:

!

Smoke

!

Drink

!

Use Marijuana

!

Use illegal drugs

Comments:

To your knowledge has the applicant ever had psychiatric treatment or any mental or emotional issues?

!

No

!

_{Yes, explain:}

Does the applicant have personality traits that may impair his/her relationship with others?

!

No

!

_{Yes, explain:}

Briefly describe the nature of the applicant’s home:

Please comment on the applicant’s family background, if known: In your opinion, what are the applicant’s motives for applying to ABI?

Would you recommend the applicant for acceptance into Alaska Bible Institute?

!

No

!

Yes

!

_{Yes, with reservations. Explain:}

If you know of further information, which in your opinion, would especially qualify or disqualify the applicant, please state it here. Remember, all information is strictly confidential.

CERTIFICATION

By signing below you certify that all the information included in this reference is complete and accurate to the best of your knowledge and that you believe the applicant possesses the qualities indicated above.

(13)

ALASKA BIBLE INSTITUTE

PERSONAL REFERENCE FORM

APPLICANT: PLEASE FILL IN YOUR INFORMATION BELOW THEN SIGN AND GIVE, WITH A STAMPED

ENVELOPE, TO YOUR PERSONAL REFERENCE. THANK YOU! Applicant Name:

Last First Middle

Initial

I, the above named applicant, waive any right I have to read or obtain copies of this recommendation, knowing that this waiver is not required as a condition for admissions.

Signature Date

BELOW THIS LINE IS TO BE FILLED OUT BY THE PERSONAL REFERENCE.

The above applicant has applied for admission to Alaska Bible Institute (ABI). Founded in 1965, ABI exists to train and equip Christians for Life and ministry. We thank you for taking the time to fill out this reference form. We greatly encourage and welcome candid responses to the following questions, as this will allow us to make the best decision for the applicant. All information will be held in strict confidence. Your prompt attention in completing this form (within 7 days) is appreciated for the applicant to continue the admission process.

This form can be completed and submitted by email, fax, mail, or in person at the ABI Main Office located in Homer, Alaska. Download this form and complete all necessary information. This form can be emailed to

Admissions@AlaskaBible.org or mailed to:

Alaska Bible Institute

c/o Admissions Department 1295 Mission Rd.

Homer, Alaska 99603

Receipt of all electronically submitted reference forms will be promptly acknowledged. If a response is not received,

(14)

!

1/2!

REFERENCE INFORMATION

Email Address:

Occupation: Relationship to Applicant:

How well do you know the applicant?

!

Very Well

!

Well

!

_Casual

How long have you known the applicant? Comments:

How well are you acquainted with the applicant’s religious/spiritual life?

!

Very Well

!

Well

!

Casual

Comments:

APPLICANT INFORMATION

Do you believe the applicant is genuinely converted?

!

No

!

Yes

What best describes the applicant’s conversion?

!

Mature

!

Genuine and Growing

!

Emotional

!

Superficial

Comments:

To what extent is the applicant active in church ministry?

With reference to their service, the applicant is:

!

Dedicated

!

Average

!

Casual

!

_Poor

Comments:

Does he/she display high moral standards?

!

No

!

_Yes

Comments:

Evaluate the applicant’s character in the following areas: Strongly Agree Agree Disagree Strongly Disagree

Exercises discretion in relationships:

!

Financially responsible:

!

Dependable:

!

Exhibits academic abilities:

!

Works well with others:

!

Capable of leading others:

!

Cares about cleanliness and hygiene:

!

Considers and prefers others:

!

Respectfully submits to authorities:

!

Self-Disciplined:

!

Demonstrates a positive self-image:

!

(15)

!

2/2! Overall, what do you consider to be the applicant’s strong points? (Include special abilities)

What could ABI do to aid the applicant’s personal development? Briefly describe any physical limitations the applicant may have:

To your knowledge does the applicant:

!

Smoke

!

Drink

!

Use Marijuana

!

Use illegal drugs Comments:

To your knowledge has the applicant ever had psychiatric treatment or any mental or emotional issues?

!

No

!

Yes, explain:

Does the applicant have personality traits that may impair his/her relationship with others?

!

No

!

Yes, explain:

Briefly describe the nature of the applicant’s home:

Please comment on the applicant’s family background, if known: In your opinion, what are the applicant’s motives for applying to ABI?

Would you recommend the applicant for acceptance into Alaska Bible Institute?

!

No

!

Yes

!

Yes, with reservations. Explain:

If you know of further information, which in your opinion, would especially qualify or disqualify the applicant, please state it here. Remember, all information is strictly confidential.

CERTIFICATION

By signing below you certify that all the information included in this reference is complete and accurate to the best of your knowledge and that you believe the applicant possesses the qualities indicated above.