APPLICATION FORM (To be completed by all applicants)

Transcription

APPLICATION FORM (To be completed by all applicants)
APPLICATION FORM
SECTION I: PERSONAL DATA (To be completed by all applicants)
1. Surname:
……………………………………………………………………………
2. First Name:
……………………………………………………………………………………..
3. Date of Birth (YYYY/MM/DD): …….. 4. Age: ………… 5. Sex: M /F………….
6. Marital Status (Married/Single/Divorced/Widowed/Other):
……………………………………………………………………
7 .Educational Qualifications :( attach copy of certificate)……………………
8. Profession: ………………… ………………………………………………
9. Residential Address: …………………………………………………………………
……………………………………………………….. Postal Code: ………
10. Postal Address if different
…………………………………………………Postal Code: ……………….
11. Country of Origin:
……………………………………………………………………
12. Contact Number: …………………………………………..
13. Email: ……………………………………..
14. Next of Kin: ………………………………………………...
15. Contact Number of next of Kin: …………………………..
SECTION II: CHURCH BACKGROUND INFORMATION (To be
completed by all applicants)
1. .Are you born again?
....................................................................................................................................
2. Do you believe you are called?
....................................................................................................................................
3. Which church do you fellowship with?
....................................................................................................................................
4. What role do you play in your church?
....................................................................................................................................
5. If you are a pastor, please indicate how long you have been pastoring?
...................................................................................................................................
SECTION III: ABS FULLTIME PROGRAMS-indicate which program you are
enrolling for, by ticking the appropriate column.
PROGRAM
Program 1
Program 2
Program 3
Program 6
Program 7:
Christian foundations Diploma
(CFD)- Minimum of two years
Church Workers Diploma
(CWD)-Minimum of one year
Lay Ministers Diploma
(LMD)- Minimum of two years
Advanced Ministers Diploma
(AMD)- Minimum of four years
DURATION
4 years
16 months
1 year
6 months
The duration of the course
depends on the pace of the
student.
Program 10
Minimum of One year
SELECTED PROGRAMS
SECTION IV: HEALTH BACKGROUND FORM
NAME ………………………………………………………………………………………………
A. Do you have any of the following Medical conditions? Tick Yes/No
1. Asthma
(Yes/No)
2. Stomach Ulcer
(Yes/No)
3. Tuberculosis
(Yes/No)
4. HIV AIDS
(Yes/No)
5. Sugar Diabetes
(Yes/No)
6. Hypertension/Other Chronic Heart Disease
(Yes/No)
7. Drug Allergies
(Yes/No)
8. Food Allergies
(Yes/No)
9. Mental illness
(Yes/No)
10. Gynecological disorders
(Yes/No)
11. Sickle Cell disease
(Yes/No)
12. Epilepsy
(Yes/No)
13. Rheumatism
(Yes/No)
Indicate other chronic diseases you suffer from…………………………………….. …..
B. Are you on any regular Medication? (Yes/No)
…………………………………...…………………………………………………………
If yes specify which medication………………………………………………….. …………
C. Have you had any major surgeries? (Yes/No) …………………………………..
D. If Yes Specify……………………………………………………………………………. .
Prospective Students are expected to answer truthfully to the above listed health
related questions. Failure to do so will result in summarily dismissal from the School
upon detection.
SECTION V: CRIMINAL RECORD (To be completed by all applicants)
1. Have you had any problems with the law? (Yes/No) ………………………..
Specify: ………………………………………………………………………………….
SECTION VII: TRAVELLING REQUIREMENTS FOR INTERNATIONAL
STUDENTS
Please make sure that you have obtained or done the following, before leaving your
country of origin.
1. Valid Passport.
2. Ghana Visa for students travelling to Ghana.
3. International Yellow Fever Vaccination Card.
4. Recent Medical Report including TB, Chest X-ray reports and HIV status.
5. Police Clearance Reports; please attach the Report with the form.
6. Start Prophylactic Anti Malaria Medications two weeks before leaving your country.
Please obtain enough dosages to continue for another 6 weeks whilst in Ghana.
SECTION VIII: RECOMMENDED BY (To be completed by all
applicants)
I am recommended by my Local Church Pastor/General Overseer/Senior Associate
Pastor/Bishop
Others (specify) …………………………………………………………………………….
I certify that the information given above is true and correct to the best of my
knowledge.
Full Name
Signature
……………………..
…………………..
Date
…………………..
NB: PLEASE EMAIL OR POST THE FOLLOWING DOCUMENTS:
1.
Completed application form
2.
Medical examination report
3.
Educational qualification/certificates
4.
Recent Police Report
5.
Letter from the person recommending you
CONTACT INFORMATION
Email: [email protected]
Postal: The Registrar, ABSF, P.O. Box 114, Korle – Bu, Accra, Ghana.
Contact numbers: +233-273-802-040, +233-244-063-136, +233-244-488-252
FOR OFFICIAL USE ONLY
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