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Admissions
Shield Baptist Institute Application Form
Full Name
*
Email
*
Phone
*
Address
*
Birthday
*
Month
Month
Day
Year
Home Church
Home Church Pastor
Home Church Phone Number
Pastoral Reference
*
Are you a pastor?
*
Yes
No
If yes, how many years?
Emergency Contact
Emergency Contact Phone Number
Marital Status
*
Married
Single
Gender
*
Male
Female
Do you have a high school diploma, G.E.D., or equivalent?
*
Yes
No
How do you plan to attend?
*
In-Person
Online (only available for nonlocal and pastors)
Which program do you intend to enroll?
*
Please give a brief summary of your Salvation Testimony
*
Application fee
$10
Application fee
Submit
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