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HOLY SPIRIT SCHOOL OF MINISTRY ON-LINE ENROLLMENT FORM
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PERSONAL INFORMATION
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(FULL LEGAL NAME (Mr.. Mrs. Ms.. Miss): FIRST NAME
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LAST NAME
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SS# (Safe and secure with Vista Print sight builder.)
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DATE OF BIRTH
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PLACE OF BIRTH (City, State, Country)
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MARITAL STATUS
SINGLE
ENGAGED
MARRIED
SEPARATED
DIVORCED
WIDOWED
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NUMBER OF CHILDREN (Give their ages)
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STREET ADDRESS
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APARTMENT NUMBER
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CITY
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STATE
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ZIP CODE
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COUNTRY
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HOME PHONE
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CELL PHONE
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EMAIL ADDRESS
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PERSONAL WEBSITE
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ADDITIONAL WEBSITE
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TESTIMONY
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HAVE YOU ACCEPTED CHRIST AS YOUR PERSONAL SAVIOR?
YES
NO
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PLEASE SHARE WITH US YOUR TESTIMONY OF HOW YOU CAME TO KNOW THE LORD AS YOUR PERSONAL SAVIOR, FILLING WITH THE HOLY SPIRIT, AND WHAT WAS IT THAT BROUGHT YOU TO THE SPIRITUAL PLACE THAT YOUR ARE NOW IN YOUR WALK WITH HIM. ALSO INCLUDE WHY YOU WANT TO JOIN THE HOLY SPIRIT SCHOOL OF MINISTRY-HSSM.
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BASED ON YOUR RELATIONSHIP, EXPERIENCES, ENCOUNTERS, AND REVELATIONS WITH THE LORD WHAT MINISTERIAL OFFICE DO YOU BELIEVE THAT HE IS CALLING YOU TO?
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HAS THIS BEEN CONFIRMED IN THE MOUTH OF TWO OR THREE AS YET?
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WHAT IS THE NAME OF YOUR MINISTRY?
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DESCRIBE YOUR MINISTRY, AND THE AREAS IN WHICH YOUR SERVE.
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DESCRIBE WHAT YOU SEE YOURSELF DOING IN THE NEAR FUTURE WHEN IT COMES TO YOUR SERVICE IN MINISTRY.
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SPIRITUAL INVENTORY
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LIST YOUR PASTORS NAME BEGINING WITH HIS/HER TITLE FOLLOWED BY LAST NAME, THEN FIRST
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LIST THE CHURCH WHERE YOU CURRENTLY HOLD MEMBERSHIP
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DENOMINATION?
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HOW LONG HAVE YOU ATTENDED?
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ARE YOU A LICENSED MINISTER?
YES
NO
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ARE YOU AN ORDAINED MINISTER?
YES
NO
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LIST THE ADDRESS OF YOUR CHURCH INCLUDING THE STREET, SUITE#, CITY, STATE, ZIP CODE, AND COUNTRY
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LIST YOUR PASTOR'S CONTACT PHONE NUMBER.
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LIST THE MINISTERIAL OFFICE THAT YOU SERVE IN AT YOUR CHURCH.
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PLEASE LIST YOUR MINISTRY WEBSITE, IF YOU HAVE ONE
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EDUCATION INFORMATION
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HAVE YOU COMPLETED HIGH SCHOOL?
YES
NO
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IF NO, DO YOU HAVE A GED?
YES
NO
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HAVE YOU COMPLETED COLLEGE?
YES
NO
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IF NOT, WHAT YEAR OF COLLEGE ARE YOU IN?
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HAVE YOU GONE BEYOND A FOUR YEAR COLLEGE DEGREE?
YES
NO
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HAVE YOU STUDIED WITH A SCHOOL OF MINISTRY?
YES
NO
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LIST ANY SPECIAL MINISTRY EXPERIENCE OR TALENT YOU HAVE.
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LIST BELOW THE NAMES OF ALL ACADEMIC INSTITUTIONS, BEGINNING WITH COLLEGE/UNIVERSITY
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NAME OF INSTITUTION?
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DATES ATTENDED FROM:
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DATES ATTENDED TO:
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MAJOR OR COURSE STUDIED?
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DEGREE RECEIVED?
YES
NO
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DIPLOMA RECEIVED?
YES
NO
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NAME OF INSTITUTION?
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DATES ATTENDED FROM:
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DATE ATTENDED TO:
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MAJOR OR COURSE OF STUDY?
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DEGREE RECEIVED?
YES
NO
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DIPLOMA RECEIVED?
YES
NO
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NAME OF INSTITUTION?
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DATES ATTENDED FROM:
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DATES ATTENDED TO:
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MAJOR OR COURSE OF STUDY?
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DEGREE RECEIVED?
YES
NO
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DIPLOMA RECEIVED?
YES
NO
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NAME OF INSTITUTION?
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DATES ATTENDED FROM:
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DATES ATTENDED TO:
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MAJOR OR COURSE OF STUDY?
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DEGREE RECEIVED?
YES
NO
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DIPLOMA RECEIVED?
YES
NO
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HEALTH INFORMATION AND EMERGENCY CONTACT
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GIVE A BRIEF STATEMENT OF THE GENERAL CONDITION OF YOUR HEALTH
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HAVE YOU BEEN DIAGNOSED WITH ANY MEDICAL ILLNESS IN THE LAST 2 YEARS? [If yes, please explain]
YES
NO
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EXPLAIN YOUR YES ANSWER HERE.
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EMERGENCY CONTACT NAME BEGINNING WITH THEIR LAST NAME FIRST
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EMERGENCY CONTACT ADDRESS INCLUDING STREET ADDRESS, APT#, CITY, STATE, ZIP CODE, AND COUNTRY
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EMERGENCY CONTACT PH#'S (Home, Work, and Cell #'s)
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REFERENCES
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PLEASE LIST ONE PERSONAL REFERENCE FROM SOMEONE WHO HAVE KNOWN YOU FOR OVER 2YRS. INCLUDE THEIR COMPLETE NAMES, ADDRESSES, AND PHONE NUMBERS.
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PLEASE LIST BELOW ONE CHARACTER REFERENCE. INCLUDE THEIR COMPLETE NAMES, ADDRESSES, AND PHONE NUMBERS (THIS MAY BE SOMEONE ELSE IN MINISTRY OTHER THAN YOUR PASTOR WHO HAS SEEN YOUR CHRIST-LIKE LIFE.)
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PLEASE LIST ONE ADDITIONAL REFERENCE FROM YOUR JOB, OR SOCIAL ENVIRONMENT. rEMEMBER THAT ALL REFERENCES MUST INCLUDE THE FULL NAMES, ADDRESSES, AND PHONE NUMBERS.
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CODE OF HONOR
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MY SIGNING TODAY IS MY ACKNOWLEDGEMENT TO HONOR THE LORD JESUS CHRIST, AND TO ADHERE TO THE FOLLOWING:
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HONOR IS ONE OF THE CORNERSTONES OF THE CHRISTIAN FAITH. IT SIGNIFIES INTEGRETY AND A GOOD NAME. IN A DEEPER SENSE, HONOR IS ACTUALLY PART OF BEING IN GOD'S PRESENCE, FOR "GLORY AND HONOR ARE IN HIS PRESENCE; STRENGTH AND GLADNESS ARE IN HIS PLACE" {1 Chronicles 16:27}. AS YOU SIGN THE FOLLOWING CODE O HONOR, YOU ARE MAKING A COMMITMENT TO GLORIFY THE LORD JESUS CHRIST WITH YOUR LIFE AND LIFESTYLE. YOU ARE ALSO RECOGNIZING THAT THE GOAL OF HOLY SPIRIT SCHOOL OF MINISTRY~HSSM IS COMMITTED TO HELPING YOU LIVE A LIFE OF HONOR AND OF THE HIGHEST REPUTATION.
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* I COMMIT TO APPLYING MYSELF WHOLEHEARTEDLY TO INTELLECTUAL PURSUITS FOR THE GLORY OF GOD.
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* I COMMIT TO GROWING IN MY SPIRITUAL PURSUITS BY DEVELOPING A PERSONAL RELATIONSHIP WITH THE LORD.
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* I COMMIT THROUGH THE STUDY OF GOD'S WORD, TO DEVELOPING THE WHOLE PERSON, SPIRIT, SOUL, AND BODY.
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* I COMMIT TO CULTIVATE GOOD RELATIONSHIPS BY A LIFESTYLE OF PURITY, INTEGRITY, AND HONESTY.
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* I COMMIT TO PROMOTING A LIFESTYLE THAT WILL INFLUENCE OTHERS TO LIVE A POSITIVE CHRISTIAN LIFE.
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* I COMMIT TO LIVING A LIFE OF PURITY AND INTEGRRITY IN THE SIGHT OF GOD AND MAN.
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* I COMMIT TO PURSUING GOD'S WILL FOR MY LIFE AND TO LIVE A LIFE OF SERVICE.
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* I COMMIT TO BEING PUNCTUAL AND ATTENDING ALL THE REQUIRED MINISTRY CLASSES.
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BY SIGNING OF THE CODE OF HONOR ACKNOWLEDGES I HAVE READ AND AGREED TO THE ABOVE CRITERIA FOR ADMITTANCE INTO HOLY SPIRIT SCHOOL OF MINISTRY~HSSM. ANY VIOLATION OF THIS CODE IS GROUNDS FOR DISMISSAL BY HOLY SPIRIT SCHOOL OF MINISTRY!HSSM
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GENERAL CONSENT
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I, THE UNDERSIGNED, DO HEREBY STATE THAT ON THE DATE INDICATED I GRANT FULL PERMISSION TO THE HOLY SPIRIT SCHOOL OF MINISTRY~HSSM OR ANY RELATED OR CONSULTING PHYSICIAN TO RENDER OR GIVE EMERGENCY MEDICAL CARE OR TREATMENT THAT IS DEEMED NECESSARY. I ALSO STATE THAT, SHOULD EXTENDED HOSPITALIZATION BE REQUIRED, I GRANT COMPLETE PERMISSION FOR SUCH CARE AND TREATMENT TO BE GIVEN. I ALSO STATE BY GRANTING SUCH PERMISSION, I ABSOLVE HOLY SPIRIT SCHOOL OF MINISTRY~HSSM OF ANY FINANCIAL LIABLITY PERTAINING TO SUCH MEDICAL TREATMENT OR HOSPITALIZATION.
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I THE UNDERSIGNED, HEREBY STATE THAT THE INFORMATION CONTAINED IN THIS APPLICATION IS TRUE AND CORRECT. I UNDERSTAND THAT IF HOLY SPIRIT SCHOOL OF MINISTRY~HSSM IS NOTIFIED THAT ANY INFORMATION CONTAINED IN THIS APPLICATION IS FALSE, IT WILL BE GROUNDS FOR EITHER DENIAL OF ADMISSION OR IMMEDIATE DISMISSAL FROM THE HOLY SPIRIT SCHOOL OF MINISTRY~HSSM.
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PLEASE SIGN AND DATE BELOW
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SIGNATURE
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DATE SIGNED
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SCHOOL OF MINISTRY COURSE ENROLLMENT
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THE FOLLOWING COURSE IS OFFERED THROUGH THE HOLY SPIRIT SCHOOL OF MINISTRY~HSSM
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NAME OF COURSE
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I WILL BE PAYING IN THE FOLLOWING MANNER-(Please check one.):
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I HAVE INCLUDED MY CASHIER'S CHECK/MONEY ORDER OF $100.00. THIS INCLUDES $50.00 TOWARDS MY APPLICATION/DEPOSTIT FEE-{This fee is non-refundable.} AND $50.00 TO WARDS MY "VICTORY DURING YOUR BATTLE IS KNOWING GOD" COURSE ENROLLMENT FEE.
YES
NO
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I HAVE INCLUDED $100.00 CASH. tHIS INCLUDES $50.00 TOWARDS MY APPLICATION/DEPOSIT FEE-{This fee is non-refundable.} AND $50.00 TOWARDS MY "VICTORY DURING YOUR BATTLE IS KNOWING GOD" COURSE ENROLLMENT FEE.
YES
NO
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I HAVE ALREADY PAID ON-LINE VIA CREDIT CARD THROUGH PAYPAL THE AMOUNT OF $100.00. THIS INCLUDES $50.00 TOWARDS MY APPLICATION/DEPOSIT FEE-{This fee is non-refundable} AND $50.00 TOWARDS MY "VICTORY DURING YOUR BATTLE IS KNOWING GOD" COURSE ENROLLMENT FEE.
YES
NO
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PLEASE LET US KNOW AT WHAT LOCATION YOU WILL BE TAKING YOUR SCHOOL OF MINISTRY COURSE.
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I WILL BE TAKING MY CLASSES AT THE HOLY SPIRIT SCHOOL OF MINISTRY~HSSM SOUTH FLORIDA LOCATION [To be announced].
YES
NO
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I WILL BE TAKING MY FIRST AND LAST CLASSES AT THE HOLY SPIRIT SCHOOL OF MINISTRY~HSSM SOUTH FLORIDA LOCATION [To be announced], AND ALL OTHER CLASSES IN BETWEEN WILL BE TAKEN ON-LINE.
YES
NO
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I WILL BE TAKING MY CLASSES ON-LINE.
YES
NO
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PLEASE BE AWARE THAT CLASSES BEGINS ON SATURDAY, JUNE 19th, 2010 FOR ALL STUDENTS WHO ARE ENROLLED IN THE SCHOOL OF MINISTRY, AND STARTING AT 11:30am SHARP, AND WILL CONTINUE FOR SIX-SEVEN WKS. AT THE SAME TIME ON SATURDAYS MORNINGS. ORIENTATION WILL BE HELD ON THURSDAY, JUNE 17TH AT 8PM SHARP. STUDENTS ARE REQUIRED TO ATTEND THE ORIENTATION AT OUR SOUTH FLORIDA LOCATION. HOWEVER, THOSE STUDENTS WHO ARE OUT OF THE LOCAL AREA MAY DOWNLOAD THE INFORMATION VIA THE WEBSITE AND/OR EMAIL, SO THAT THEY WILL BE PREPARED FOR WEB ORIENTAION VIEWING VIA THE INTERNET. YOU MAY VIEW THE DROP-DOWN SCHEDULE BELOW OF CURRENT AND FUTURE PROGRAM DATES THROUGH THE END OF 2010.
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SCHOOL OF CHAPLAINCY COURSE ENROLLMENT
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THE FOLLOWING COURSES ARE OFFERED THROUGH THE HOLY SPIRIT SCHOOL OF MINISTRY~HSSM CHAPLAINCY SCHOOL
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NAME OF COURSES
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I WILL BE PAYING IN THE FOLLOWING MANNER-(Please check one.):
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I HAVE INCLUDED A CASHIER'S CHECK/MONEY ORDER OF $150.00-{$50.00 IS non-refundable} REGISTRATION/DEPOSIT FEE TOWARDS THE CHAPLAINCY PROGRAM COURSES.
YES
NO
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I HAVE INCLUDED $150.00-{$50.00 is non-refundable} REGISTRATION/DEPOSIT FEE TOWARDS THE CHAPLAINCY PROGRAM COURSES.
YES
NO
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I HAVE ALREADY PAID MY $150.00-{$50.00 is non-refundable} REGISTRATION/DEPOSIT FEE TOWARDS THE CHAPLAINCY PROGRAM COURSES ON-LINE VIA CREDIT CARD THROUGH PAYPAL.
YES
NO
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I HAVE ALREADY PAID MY $150.00-{$50.00 is non-refundable} REGISTRATION/DEPOSIT FEE TOWARDS THE CHAPLAINCY PROGRAM COURSES ON-LINE VIA PAYPAL.
YES
NO
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PLEASE LET US KNOW AT WHAT LOCATION YOU WILL BE TAKING YOUR SCHOOL OF CHAPLAINCY CLASSES.
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I WILL BE TAKING MY CLASSES AT THE HOLY SPIRIT SCHOOL OFMINISTRY~HSSM SOUTH FLORIDA LOCATION-[TO BE ANNOUNCED].
YES
NO
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I WILL BE TAKING MY FIRST AND LAST CLASSES AT THE HOLY SPIRIT SCHOOL OF MINISTRY~HSSM SOUTH FLORIDA LOCATION, AND ALL OTHER CLASSES IN BETWEEN WILL BE TAKEN ON-LINE.
YES
NO
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I WILL BE TAKING ALL MY CLASSES ON-LINE.
YES
NO
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PLEASE BE AWARE THAT CLASSES BEGINS ON TUESDAY, June 22nd, 2010 FOR ALL STUDENTS WHO ARE ENROLLED IN THE SCHOOL OF CHAPLAINCY, AND STARTING AT 12:30pm SHARP DAYS & 7:30pm SHARP NIGHTS, AND WILL CONTINUE FOR SIX-SEVEN WKS. AT THE SAME TIME TUESDAYS & THURSDAY NIGHTS. ORIENTATION WILL BE HELD ON SATURDAY, JUNE 19TH AT 8:00PM SHARP. STUDENTS ARE REQUIRED TO ATTEND THE ORIENTATION AT OUR SOUTH FLORIDA LOCATION. HOWEVER, THOSE STUDENTS WHO ARE OUT OF THE LOCAL AREA MAY DOWNLOAD THE INFORMATION VIA THE WEBSITE AND/OR EMAIL, SO THAT THEY WILL BE PREPARED FOR WEB ORIENTAION VIEWING VIA THE INTERNET. YOU MAY VIEW THE DROP-DOWN SCHEDULE BELOW OF CURRENT AND FUTURE PROGRAM DATES THROUGH THE END OF 2010.
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BELOW IS A CALENDAR SCHEDULE OF ALL OUR FUTURE SCHOOL OF MINISTRY COURSES. PLEASE CHECK BELOW THE DATES THAT YOU ARE NOW ENROLLING FOR.
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BELOW IS A CALENDAR SCHEDULE OF ALL OUR FUTURE SCHOOL OF CHAPLAINCY COURSES. PLEASE CHECK BELOW THE DATES THAT YOU ARE NOW ENROLLING FOR.
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WHICH IS THE BEST DAY TO CONTACT YOU?
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WHAT IS THE BEST TIME TO REACH YOU?
Hours
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Minutes
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GOD BLESS YOU, AND THANK YOU FOR TAKING THE TIME TO COMPLETE THIS ENROLLMENT FORM. YOU WILL BE CONTACTED WITH A FOLLOW-UP INTERVIEW TO CONTINUE THE PROCESS.
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