ISoM Application - Bethesda

Administrative Office Address: 2738 Ring Rd, Elizabethtown, KY 42701
Phone Number: 270-900-1290
E-mail: Impactministryky@gmail.com

Please Submit the Following With Your Application

A professional photo of yourself (professional in appearance, does not have to be professionally taken).
Any transcripts from previously attended colleges or universities.
A non-refundable application fee (Undergraduate: $50, Graduate: $100).
Your application essay.

Please Submit Your Essay To The Administrative Office E-mail Address Or Attach Your Essay At The End Of This Form

Please submit a typed Christian experience essay of at least 250 words (this is about 1 page, double-spaced). Please describe both your spiritual and academic goals and how you believe Impact School of Ministry can help you achieve them. In your essay, please explain how you came to faith in Christ, your assurance of salvation, your goals for the future and your spiritual growth.

Full Name:

Date of Birth:

Address:

Phone Number:

E-mail:

Citizenship:

Gender:

Male Female

Marital Status:

Married Single

Have You Ever Served In The Military?:

Yes No

If 'Yes', What Military Branch:

Home Church:

Address:

Denomination:

Pastor's Name:

Church Phone Number:

List Any Ministries You Have Served In:

Are You Currently Employed?:

Yes No

Employer's Name (If Applicable):

Job Title:

Enrollment Status:

Full-Time Part-Time Audit Unsure

Degree to Obtain:

Associate's Bachelor's Masters Doctorate

Starting Semester:

Fall Spring Right Away

Program Attending:

Affiliate Campus Distance Learning

College/University Name(s):

Dates Attended:

Credits Earned:

GPA:

High School Name Attended / GED:

Address(es)

Graduated / Obtained GED:

Yes No

Years Completed:

Reference 1 Name:

Reference 1 Address:

Reference 1 Title:

Reference 1 Relationship:

Reference 2 Name:

Reference 2 Address:

Reference 2 Title:

Reference 2 Relationship:

Reference 3 Name:

Reference 3 Address:

Reference 3 Title:

Reference 3 Relationship:

Upload Essay:

Photo Upload:

I certify that all information in this form is accurate and truthful in all regards.

Applicant's E-Signature:

Date of Application:

Impact School of Ministry does not discriminate on basis of race, color, or origin in its administration. ISM is nondiscriminatory in admissions and access of to treatment of in its programs and activities with respect to those with impaired vision, hearing, or physical mobility.

Sunday Service:

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Administrative Office

Please Submit the Following With Your Application

Essay Information

Please Submit Your Essay To The Administrative Office E-mail Address Or Attach Your Essay At The End Of This Form