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Full Name *
First Name
Last Name
Social Security #:*
Present Address *
Address Line 1
Address Line 2
Postal Code
Phone Number:*
Email Address:*
I am interested in one of the following programs: *
Personal Data: These questions are being asked on a voluntary basis for statistical purposes. They are not being asked as a criteria for admission.
Date of Birth
US Citizen:
Country of present citizenship if not US citizen:
VISA Type:
VISA/Permanent residency number:
Marital Status:
Denominational Affiliation:
Church Name:
Are you ordained or licensed as a Minister, Deacon or other service?
If yes, please specify:
What church activities are you involved in?
Why are you interested in this program?
Current Employer:
Job Title:
Starting Date of Employment
Ending Date of Employment:
Name of High School Attended
Diploma or GED
Date Received:
Name of College or University Attended
Dates Attended:
Verification: I hereby acknowledge that the above information is accurate and complete and that any false or misleading statements on this application could be cause for dismissal from Heritage Center. I understand the following policy on tuition/fee refunds: The tuition and fees paid by the applicant shall be refunded if the applicant is rejected by the school before enrollment. An application fee of not more than $25.00 may be retained by the school if the application is denied. All tuition and fees paid by the applicant shall be refunded if requested within 3 business days after signing a contract with the school. All refunds shall be returned within 30 days. Once the 3 business days have elapsed, the following refund policy will apply: (1) 100% tuition/fee refunds will be granted through the first 5 days of the quarter, (2) no refunds will be granted after 5 days. Additionally, I agree to adhere to the conduct norms, policies and regulations of Heritage Center.
By pressing Submit you agree to the terms and conditions listed and hereby submit your application for enrollment in Heritage Center
Heritage Center for Religious Studies does not discriminate on the basis of religion, race, color, national origin, sex, disability, age or marital status.