($25 Mail-In Application Fee)
STUDENT INFORMATION

* REQUIRED INFO
* First Name
* Last Name
* Current Address
* City
*State
 * Zip Code
* Home Phone
 () -
Cell Phone
 () -

* e-mail Address
* Date of Birth
/ /

* Age
* Social Security No.
 - -
Shirt Size
Ring Size?
* Relational Status
 Single   Dating   Engaged   Married   Divorced  
* Year of Graduation or GED
Children?
 Yes   NoAges
Custody

MOTHER'S INFORMATION

* REQUIRED INFO
* First Name
* Last Name
* Current Address
* City
*State
 * Zip Code
* Daytime Phone
 ( ) -
Evening Phone
 ( ) -

* e-mail Address
* Occupation

* Accepted Christ?

 Yes    No
* Is your mother / guardian in favor of you attending SCMC?
 Yes    No

FATHER'S INFORMATION

* REQUIRED INFO
* First Name
* Last Name
* Current Address
* City
*State
 * Zip Code
* Daytime Phone
 ( ) -
Evening Phone
 ( ) -

* e-mail Address
* Occupation

* Accepted Christ?

 Yes    No
* Is your father / guardian in favor of you attending SCMC?
 Yes    No

REFERENCES
* REQUIRED INFO

* Name
* Relation
*Phone

* Name
* Relation
*Phone

* Name
* Relation
*Phone

HEALTH INFORMATION
* Please answer the following questions honestly; responses are used for confidential informational purposes and will not solely affect acceptance.
* REQUIRED INFO

* How would you describe the condition of your health?

* Have you been diagnosed with any physical, emotional or learning conditions?

 if yes, please specify below

Please describe any treatments, including medications, for the above listed conditions:

*Please list any prescription or over-the-counter medications you are currently taking on a regimen:

* Have you ever consulted professional counseling/therapy?
* Reason?
(if Yes)

* Have you ever used illegal drugs?
* Date of Last Use?

* Have you ever smoked tobacco?
* Date of Last Use?

* Have you ever consumed alcohol?
* Date of Last Use?

* Do you have health insurance?

ECONOMIC STANDING
* REQUIRED INFO

* Do you own a vehicle?
*students are responsible for their own transportation
Is your vehicle insured?

EMPLOYMENT

*Current Employer:
*Possition:
*Date Hired:

*Previous Employer:
*Possition:
*Date Hired:

*Date Released:
*Reason for Release:

DEBTS

Please list any debts, outstanding loans, or other payments your presently have and indicate the amount due for each:

* Will these debts be paid off by the start of the year?
* If "No" When will they be paid off?

How do you plan to make payments on your debts while in South Carolina Masterʼs Commission?

TUITION

* What financial payment option do you expect to use to pay for your tuition?

* How do you plan to pay for your tuition?

* Who is responsible for the full payment of your tuition?

If "Other" Please Specify:

CHURCH INFORMATION
* REQUIRED INFO

* Name of Church:

* Address:

* City:
*State:
*Zip:
*Phone:
 ( ) -
Email:

*Senior Pastor:
*Youth Pastor :

* Are you an official member of your church?

Yes   No

* How and when did you accept Christ?:

* List the different ministries that you have been or are currently involved in:

SHORT ANSWER
* REQUIRED INFO

What are some of the necessary qualities you feel you must have to be a spiritual leader?

Have you ever been criminally convicted? (If Yes, please describe the circumstances below)

What do you plan to do after South Carolina Masterʼs Commission?

* How did you hear about South Carolina Masterʼs Commission?
*If "Event" or "Other", Please Specify

ESSAY

Please answer the following questions in a typed short essay of 200-300 words using the text box below:
(1) Why do you desire to attend South Carolina Masterʼs Commission?
(2) What would you like to gain personally as a result of attending South Carolina Masterʼs Commission?

You may want to write your essay separately and then copy it into the text box below.


Please attach a photo of yourself to an email and send it here.

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