Personal
Data
First Name:*
Last Name:*
Middle Initial:
Mailing Address:*
City:*
State (for non-US residents place your information in the Country form below):*
AL
AK
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
Other (Non-US)
Zip:*
e-mail:*
Home Phone Number:*
Cell Phone Number:*
Country:
First Language (if other than English):
Marital Status:
single
married
Gender:
male
female
Date of Birth:
Have you ever contacted The Kaleo Institute before?
yes
no
How did you hear about The Kaleo Institute?
How did you hear about BCC?
Online Search
Radio Ad
A Friend
My Pastor or Church
CHEA Website
Print Ad
ABHE Website
CPCA Website
FCPC Website
Other
If you answered Pastor, church, friend, or other can you tell us who?:
Professional
Data
Current Occupation
Years in your current occupation
None
Less than One
1 to 3 years
4 to 6 years
6 or 10 years
10 or more years
How would you describe your ministry experience?
Choose one of the following options:
currently
employed in full-time ministry
currently
employed in part-time ministry
currently
a bi-vocational minister
currently
serving in volunteer ministry and wish to enter a paid position
currently
in secular vocation and wish to enter full or part-time ministry
formerly
in full or part time-ministry and desire to return
Number of years you have served in full
time ministry:
None
Less than One
1 to 3 years
4 to 6 years
6 or 10 years
10 or more years
Number of years you have served in part
time ministry:
None
Less than One
1 to 3 years
4 to 6 years
6 or 10 years
10 or more years
Number of years you have served in volunteer
ministry:
None
Less than One
1 to 3 years
4 to 6 years
6 or 10 years
10 or more years
Your church denomination/background:
Name of church that you currently attend:
Degree that you wish to earn:
Please Select the desired Degree
Associate of Ministries
Bachelor of Arts in Ministries/Worship Ministries
Bachelor of Arts Ministries/ Pastoral Ministries Electives
Bachelor of Arts in Ministries/ Womens Ministries Electives
Bachelor of Arts in Ministries/ Youth Ministries Electives
Bachelor of Arts in Ministries/ Christian Counseling Ministries Electives
Bachelor of Arts in Ministries/ Christian Education Electives
Master of Ministries
Are you interested in the fully online or a hybrid (online complemented by on campus lecture and discussion) program?:
Please Select a modality
Online
Online complemented by on campus learning at the Jacksonville or Daytona Beach, Florida Learning Center
Educational
Data
Name of your first college/university
attended (if applicable):
Dates of attendance:
Credits earned:
Major:
Degrees earned and dates:
Name of second college/university attended
(if applicable):
Dates of attendance:
Credits earned:
Major:
Degrees earned and dates:
Name of Third college/university attended
(if applicable):
Dates of attendance:
Credits earned:
Major:
Degrees earned and dates:
Please list any additional school information
here :
Life Learning Experience (include certificates,
diplomas, trade schools, military, business courses, other
formal learning courses):
Financial
Aid Application
I would like to request financial aid:
1. Are you presently working in full-time
or part-time ministry?
Choose one of the
following options:
full-time ministry
part-time ministry
Not employed in
ministry
2. Number of Dependents:
None
One
Two
Three
Four
Five
Six or more
3. Do you own your own home?
Yes, I own my home
No, I do not own
my home
4. If you do not own your home, choose
one:
Choose one of the following options:
rent
parsonage
other
5. Income level: My total family yearly
income is:
Less than $15000
$15k-20k
$20k-$25k
$25k-$30k
$30k-$35k
$35k-$40k
$40k-$50k
$50k and above
6. How do you specifically plan to benefit from,
or use, your Kaleo Institute education?
7. Please list an other circumstances
that you feel would qualify you for financial aid:
Computer
information
Is the computer that you will be using for
your online studies Windows or Mac?
Windows
Mac
What is the current operating system of the
computer that you will be using for your online work?
Windows 7 or above
Windows Vista
Windows XP
Mac OS8-9
Mac OSX or above
Please enter the password you would like to
use for online access (required):
Please enter your first initial, middle initial and last name
(for ex. John Charles Smith would be jcsmith) this will serve as your
username while in the program (required):
Informal Interview with Academic Specialist
The Kaleo Institute would love to have the opportunity to speak with you directly in an informal telephone interview process. This is a wonderful opportunity for you as a student and for us as a school to get to know each other. Please list convenient times to reach you (include days of the week and times of the day that you are available) as well as the best telephone number to try.
Online Signature and
Date
I certify the above information to be accurate and truthful to the best of my knowledge (type your name here):
Todays Date (MM-DD-YYYY):