Admissions

Shield Baptist Institute Application Form

Full Name*

Email*

Phone*

Address*

Birthday*

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

$10Application fee

(828)-652-7729 EXT. 103

bottom of page