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DEGREE STUDENT

APPLICATION

Student Paper Writing

PERSONAL INFORMATION

First Name

Last Name

Date of Birth

Email Address

Phone

Gender *

Male

Female

Street Address

Street Address Line 2

City

Region/State/Province

Postal / Zip code

Country

Country of Citizenship

Ethnicity

Are you currently, or have you ever, served as a police officer, firefighter, EMS, or in the military? *

Yes

No

Marital Status *

Single

Married

SPIRITUAL PROFILE

Name of Home Church

Denomination

Church Address

Pastor's Name

Church Phone Number

Briefly describe your salvation story.

List any ministries that you have served in.

ENROLLMENT INFORMATION

Select the academic program you wish to apply to.

Student Enrollment Status *

Part-Time

Full-Time

Will you be taking classes through an affiliate campus? *

Yes

No

If yes, please indicate which affiliate campus you are a part of.

EDUCATION

Have you received a high school diploma or equivalent? *

Yes

No

If yes, please indicate what you have (Diploma, Homeschool Certificate, GED).

If no, please explain your situation (did not finish HS, seeking dual enrollment).

Do you have any prior college experience? *

Yes

No

College or University Name #1

Area of Study

College or University Name #2

Area of Study

Upload Unofficial Transcripts: If you have previous college experience, please upload an unofficial transcript for each college you attended. An official transcript should be mailed as well to: VCBCS Administrative Office PO Box 622, Hudson, NY 12534

Upload File

Upload supported file (Max 15MB)

Photo: Please upload a photo. The photo should be of just you.

Upload File

Upload supported file (Max 15MB)

E-Signature: I certify the above information is accurate and truthful in all regards.

Thanks for submitting! In order to process your application, please pay the application fee.

Undergraduate Program: $50

Graduate Program: $100

CONTACT US

Send us a message

Email: admin@vcbcs.org
Tel: 844-863-7847

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