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Name
____________________________________________________________________ |
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Sex: _______Male
_______ Female |
Age: _______________ |
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Address:
__________________________________________________________________ |
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City:
_________________________________ |
State: _________ |
Zip:
____________________ |
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Home Phone: ( ______ )
__________________ |
Work Phone: ( ______ )
_______________________ |
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Degree(s)
now held:
__________________________________________________________________ |
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Which
Program would you like to enroll?
_________________________________________________ |
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What
name do you desire to appear on your Degree? (Please
use exact spelling of your name)
_____________________________________________________ |
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Occupation:
_______________________________________________________________________ |
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Employer:
_________________________________________________________________________ |
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Employer's
Address:
_________________________________________________________________ |
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City:
________________________________ |
State: _________ |
Zip:
____________________ |
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CONTRACT
In consideration of
Christian Bible College (CBC) accepting the undersigned as a student
of its Christian Educational Program, the undersigned agrees to pay
appropriate scheduled fees and acknowledges that no refund will be
made. If financed by CBC, one payment per month is required unless
other arrangements are made. If three (3) consecutive payments are
missed the balance becomes payable in full. If not paid, CBC will no
longer maintain student file and appropriate action will follow.
And in acceptance of
this student's application and registration, Christian Bible College
agrees to provide to the undersigned a course of Christian
educational instruction in accordance with its regularly developed
or special curriculum. Financial commitment is only for each
one-year program. |
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Signature of Student:
_______________________________________________________ |
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This the ______ day of
____________ (year) |
Social Security #
____________________ |
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Credit
Card Type: ______________________ |
Number:
__________________________________ |
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Expiration
Date: _______________________ |
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BONUS: Save
20% for cash payment on tuition and fees • Send
(minimum) $325.00 to enroll
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Down Payment:
$__________________ |
Balance Due:
$___________________ |
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$_____________ per month until balance is paid in full, according to CBC Cost
Schedule. First
payment is due thirty (30) days after initial registration
arrangements;
remaining payments due same date each month
thereafter.
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