Kauai Bible College

*First Name:

*Last Name:

Middle Name:

Date of Birth:
00/00/000

Age When Attending:
Please give us the age you will be when you start your Bible College semester here in Kauai.

Gender: Male Female

Street Address:

Street Address Continued:

City:

State:

Zip Code or Postal Code:

Country:

Home Phone:

Cell Phone:

*Email Address:

Citizenship:

Place of Birth:

Semester of Entry: Fall 2009 Spring 2010 Fall 2010 Spring 2011
What semester do you intend to begin attending Kauai Bible College?

Student Housing On Campus Off Campus
Are you applying to live on or off campus?

Current Home Church?
What church do you activily attend?

Current Pastor:
Who would you consider as your pastor?

Marrital Status: Single Engaged Married Divorced

What is your spouses Name:

Number of Children:

Schools attended since highschool:
This list can include the highschool you graduated from as well as any other colleges you attended.

Are you a smoker? Yes No

Do you drink alcoholic beverages? Yes No

Have you ever used any illegal drugs? Yes No

If you answered "yes" to the preceding question please explain here:

Have you ever been convicted of a felony? Yes No

If you answered "yes" to the former question please explain here:

Do you have a history of violence toward others? Yes No

If you answered "yes" to the former question please explain here:

Do you have a history of sexual immorality? Yes No

Please list the preachers/teacher who have most influenced your life:

How did you hear about Kauai Bible College Calvary Chapel Bible College Murrieta A CCBC Extension Campus A Former Student Google Facebook Twitter A Ministry Leader

Please Attach Your Spiritual Bio Here:
This is a short paper describing your testimony and what God is doing in your life now. Tell us about your life before you came to Christ, how you came to Christ, and your life after you were saved. You can upload any kind of document, but .pdf and Word documents are best.

Will you abide by the Student Guidlines while enrolled at KBC? Yes No

Have you answered all the questions above truthfully? Yes No

*Required